Pelvic Floor Service, Department of General Surgery, University Hospital South Manchester NHS Trust, Wythenshawe Hospital, Manchester, United Kingdom.
Dis Colon Rectum. 2011 Sep;54(9):1122-8. doi: 10.1097/DCR.0b013e318223fbcb.
Anal acoustic reflectometry is a new technique of assessing anal sphincter function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, the opening and closing elastance, and hysteresis.
This study aimed to compare the reproducibility of this new technique, in terms of test-retest and interrater reliability, with manometry, the current standard test of sphincter function.
This is a comparative study of reproducibility between anal acoustic reflectometry and manometry.
This study was conducted at a university hospital (outpatient clinic and endoscopy unit).
Twenty-six (21 female) subjects were assessed with both anal acoustic reflectometry and manometry on 2 separate occasions (test-retest reliability) and 22 (16 female) subjects were assessed with both methods by 2 separate investigators (interrater reliability).
Reproducibility was assessed according to the Bland-Altman method.
All of the measured novel anal acoustic reflectometry parameters had acceptable mean differences and repeatability coefficients. Comparison of the 2 methods of sphincter assessment (anal acoustic reflectometry vs manometry) was made for measurements taken at rest and during voluntary contraction. There was no significant difference in terms of test-retest reliability between the manometry maximum resting pressure vs the reflectometry opening pressure (P = .57) or manometry maximum squeeze pressure vs the reflectometry squeeze opening pressure (P = .68). No significant difference between methods was found in interrater reliability during assessments at rest (P = .62) and voluntary contraction (P = .96).
Anal acoustic reflectometry is limited, as with all tests of anorectal function, in that the device is placed within the anal canal, causing stimulation of sensory and stretch receptors.
Anal acoustic reflectometry has a reproducibility comparable to manometry in terms of both test-retest and interrater reliability. Anal acoustic reflectometry is a promising technique that allows an assessment of anal canal physiology that is not available with manometry.
分析声学反射仪是一种评估肛门括约肌功能的新技术。该技术可以测量 5 个新变量，以反映肛门管的功能：开口和闭合压力、开口和闭合弹性以及滞后。
本研究旨在比较分析声学反射仪与目前评估括约肌功能的标准测试——测压法在测试-再测试和观察者间可靠性方面的重复性。
这是一项关于分析声学反射仪与测压法之间可重复性的对比研究。
该研究在一所大学医院（门诊和内窥镜室）进行。
26 名（21 名女性）患者分别接受了两次分析声学反射仪和测压法的检查（测试-再测试可靠性），22 名（16 名女性）患者由两名不同的研究者接受了这两种方法的检查（观察者间可靠性）。
根据 Bland-Altman 方法评估可重复性。
所有新的分析声学反射仪参数的测量值都具有可接受的平均差异和重复性系数。对两种评估括约肌的方法（分析声学反射仪与测压法）在静息和自主收缩时的测量值进行了比较。在静息状态下，测压法最大静息压与反射仪开口压（P =.57）或测压法最大收缩压与反射仪收缩开口压（P =.68）之间的测试-再测试可靠性无显著差异。在静息（P =.62）和自主收缩（P =.96）状态下，两种方法之间的观察者间可靠性也无显著差异。
与所有肛门直肠功能测试一样，分析声学反射仪受到限制，因为设备放置在肛门管内，会刺激感觉和牵张感受器。
在测试-再测试和观察者间可靠性方面，分析声学反射仪与测压法具有相似的可重复性。分析声学反射仪是一种很有前途的技术，它可以评估肛门管的生理功能，而这是测压法无法实现的。
