Yamamoto Atsushi, Kessoku Takaomi, Ogata Tomoki, Jono Tsumugi, Takahashi Kota, Tanaka Kosuke, Suzuki Ko, Takeda Yuma, Ozaki Anna, Kasai Yuki, Okubo Naoki, Iwaki Michihiro, Kobayashi Takashi, Misawa Noboru, Yoshihara Tsutomu, Suzuki Akihiro, Fuyuki Akiko, Hasegawa Sho, Imajo Kento, Kobayashi Noritoshi, Matsumoto Masaru, Tamai Nao, Sanada Hiromi, Oyamada Shunsuke, Ichikawa Yasushi, Nakajima Atsushi
Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
Department of Gastroenterology, Fujisawa Syonandai Hospital, Fujisawa 252-0802, Japan.
Diagnostics (Basel). 2024 Jul 28;14(15):1626. doi: 10.3390/diagnostics14151626.
Although handheld ultrasound devices (HUDs) are commonplace, their ability to diagnose fecal retention (FR) remains unclear. This prospective observational study examined HUDs' usefulness in diagnosing FR in patients with constipation in a palliative care setting. Between 10 December 2020 and 30 June 2022, we compared rectal ultrasonographic findings obtained using HUDs with clinical manifestations in 64 males and 70 females (48%, 52%, 68 ± 11 years old) with constipation who had undergone computed tomography (CT). FR was diagnosed using a HUD and compared with CT and digital rectal examination (DRE) results. In total, 42 (31%), 42 (31%), and 41 (31%) patients were diagnosed using HUDs, CT, and DRE, respectively. Thirty-nine (93%) patients in the CT group were also diagnosed with FR using HUDs. A total of 89 of 92 patients with a negative CT diagnosis also had a negative HUD diagnosis. Among the 41 patients in the DRE group, 37 were also diagnosed with FR using HUDs. Among 93 patients with a negative DRE diagnosis, 86 had a negative HUD diagnosis. The sensitivity, specificity, positive predictive value, and negative predictive value of HUDs for CT were 93%, 97%, 93%, and 97%, respectively. Those of HUDs for DRE were 88%, 94%, 86%, and 95%, respectively. The concordance rates for FR diagnosis were 128/134 for CT and HUDs and 123/134 for DRE and HUDs. HUD was useful for diagnosing FR in this setting. HUDs could provide valuable support for appropriate treatment selection. Developing a constipation treatment algorithm based on rectal ultrasonographic findings is warranted in the future.
尽管手持式超声设备（HUDs）很常见，但其诊断粪便潴留（FR）的能力仍不明确。这项前瞻性观察性研究探讨了HUDs在姑息治疗环境中诊断便秘患者FR的效用。在2020年12月10日至2022年6月30日期间，我们将使用HUDs获得的直肠超声检查结果与64名男性和70名女性（分别占48%、52%，年龄68±11岁）便秘患者的临床表现进行了比较，这些患者均接受了计算机断层扫描（CT）。使用HUD诊断FR，并与CT和直肠指检（DRE）结果进行比较。总共分别有42例（31%）、42例（31%）和41例（31%）患者通过HUDs、CT和DRE诊断为FR。CT组中有39例（93%）患者也通过HUDs诊断为FR。92例CT诊断为阴性的患者中，共有89例HUD诊断也为阴性。在DRE组的41例患者中，有37例也通过HUDs诊断为FR。在93例DRE诊断为阴性的患者中，有86例HUD诊断为阴性。HUDs对CT的敏感性、特异性、阳性预测值和阴性预测值分别为93%、97%、93%和97%。HUDs对DRE的敏感性、特异性、阳性预测值和阴性预测值分别为88%、94%、86%和95%。CT和HUDs对FR诊断的一致性率为128/134，DRE和HUDs对FR诊断的一致性率为123/134。在这种情况下，HUD对诊断FR很有用。HUDs可为适当的治疗选择提供有价值的支持。未来有必要基于直肠超声检查结果制定便秘治疗算法。
