Investigation of optimal cues to instruction for pelvic floor muscle contraction: a pilot study using 2D ultrasound imaging in pre-menopausal, nulliparous, continent women.

Aims: Optimal urethrovesical positioning (UVP) may be important for continence. Pelvic floor muscle contraction (PFMC) influences UVP. PFMC instruction cues vary and often encourage anterior PFM recruitment that may result in sub-maximal posterior facilitation.

Functional imaging of the pelvic floor.

The clinical treatment of patients with anorectal and pelvic floor dysfunction is often difficult. Dynamic cystocolpoproctography (DCP) has evolved from a method of evaluating the anorectum for functional disorders to its current status as a functional method of evaluating the global pelvic floor for defecatory disorders and pelvic organ prolapse. It has both high observer accuracy and a high yield of positive diagnoses.

Feasibility of video capsule endoscopy in the management of children with Peutz-Jeghers syndrome: a blinded comparison with barium enterography for the detection of small bowel polyps.

Objectives: Peutz-Jeghers syndrome (PJS) in children may present with anaemia, intussusception, or obstruction from an early age and surgery is common. Prophylactic polypectomy may reduce subsequent complications. Traditional barium enterography (BE) has poor sensitivity and requires significant radiation.

Effect of temporal interval between scan acquisitions on quantitative vascular parameters in colorectal cancer: implications for helical volumetric perfusion CT techniques.

Objective: The purpose of this study was to determine how the temporal interval between scan acquisitions influences quantitative perfusion CT vascular parameters in colorectal cancer.

Subjects And Methods: Forty-five patients with colorectal adenocarcinoma prospectively underwent a 65-second single-anatomic-level perfusion CT study. Blood flow, blood volume, transit time, and permeability-surface area product for a 2-cm tumor coverage were determined with commercial software based on distributed parameter analysis for four temporal intervals (1, 2, 3, and 4 seconds) between acquisitions.

Colorectal tumor vascularity: quantitative assessment with multidetector CT--do tumor perfusion measurements reflect angiogenesis?

Purpose: To establish the relationships between quantitative perfusion computed tomography (CT) parameters-specifically, primary tumor blood flow, blood volume, transit time, and permeability surface-area product-and immunohistologic markers of angiogenesis in colorectal cancer.

Materials And Methods: After institutional review board approval and informed patient consent were obtained for this prospective study, 23 patients (11 men, 12 women; mean age, 68.4 years; age range, 34.

Can perfusion CT assessment of primary colorectal adenocarcinoma blood flow at staging predict for subsequent metastatic disease? A pilot study.

We aimed to determine whether perfusion CT measurements at colorectal cancer staging may predict for subsequent metastatic relapse. Fifty two prospective patients underwent perfusion CT at staging to estimate tumour blood flow, blood volume, mean transit time, and permeability surface area product. Patients considered metastasis free and suitable for surgery underwent curative resection subsequently.

Quantitative assessment of colorectal cancer tumor vascular parameters by using perfusion CT: influence of tumor region of interest.

Purpose: To prospectively determine whether position and size of tumor region of interest (ROI) influence estimates of colorectal cancer vascular parameters at computed tomography (CT).

Materials And Methods: After institutional review board approval and informed consent, 25 men and 22 women (mean age, 65.8 years) with colorectal adenocarcinoma underwent 65-second CT perfusion study.

Quantitative tumor perfusion assessment with multidetector CT: are measurements from two commercial software packages interchangeable?

Purpose: To prospectively determine the level of agreement between tumor blood volume and permeability measurements obtained with two commercially available perfusion computed tomographic (CT) software packages.

Materials And Methods: This study was performed with institutional review board approval; informed consent was obtained from all participants. A total of 44 patients (24 men, 20 women; mean age, 68 years; range, 28-87 years) with proved colorectal cancer were examined prospectively with multi-detector row CT.

Differentiation between diverticulitis and colorectal cancer: quantitative CT perfusion measurements versus morphologic criteria--initial experience.

Purpose: To determine whether computed tomographic (CT) perfusion measurements in prospectively recruited patients can be used to differentiate between diverticulitis and colorectal cancer and to compare this discrimination with that of standard morphologic criteria.

Materials And Methods: After institutional review board approval and written informed consent were obtained, 60 patients (24 men, 36 women; mean age, 69 years; range, 33.5-90.

Dynamic imaging of posterior compartment pelvic floor dysfunction by evacuation proctography: techniques, indications, results and limitations.

The clinical management of patients with anorectal and pelvic floor dysfunction is often difficult. Evacuation proctography has evolved from a method to evaluate the anorectum for functional disorders to its current status as a practical method for evaluating anorectal dysfunction and pelvic floor prolapse. It has a high observer accuracy and yield of positive diagnosis.

Quantitative assessment of tissue perfusion using MDCT: comparison of colorectal cancer and skeletal muscle measurement reproducibility.

Objective: The purposes of this study were to determine the reproducibility of quantitative colorectal cancer perfusion measurements using dynamic contrast-enhanced MDCT, and to compare this with measurements from skeletal muscle.

Subjects And Methods: Ten patients (mean age, 67 years; six men, four women) with histologically proven colorectal cancer were examined prospectively using 4-MDCT. Perfusion studies (cine mode; 4 x 5 mm collimation; 1 acquisition/s; 65 seconds total) were performed through the tumor epicenter after IV bolus contrast administration (iopamidol 340, 100 mL; 5 mL/s) and repeated within 48 hours.

Polyp measurement using CT colonography: agreement with colonoscopy and effect of viewing conditions on interobserver and intraobserver agreement.

Objective: This article presents inter- and intraobserver agreement for estimates of polyp diameter using CT colonography, including the effects of different visualization displays and prior experience.

Materials And Methods: Four observers, three of whom had prior experience with CT colonography, estimated the maximum diameter of 48 polyps using three different visualization displays: 2D colonography window, 2D abdominal window, and 3D surface rendering. Each re-measured a subset of 10 polyps.

Polyp measurement and size categorisation by CT colonography: effect of observer experience in a multi-centre setting.

The extent measurement error on CT colonography influences polyp categorisation according to established management guidelines is studied using twenty-eight observers of varying experience to classify polyps seen at CT colonography as either 'medium' (maximal diameter 6-9 mm) or 'large' (maximal diameter 10 mm or larger). Comparison was then made with the reference diameter obtained in each patient via colonoscopy. The Bland-Altman method was used to assess agreement between observer measurements and colonoscopy, and differences in measurement and categorisation was assessed using Kruskal-Wallis and Chi-squared test statistics respectively.

CT colonography interpretation times: effect of reader experience, fatigue, and scan findings in a multi-centre setting.

Our purpose was to assess the effect of reader experience, fatigue, and scan findings on interpretation time for CT colonography. Nine radiologists (experienced in CT colonography); nine radiologists and ten technicians (both groups trained using 50 validated examinations) read 40 cases (50% abnormal) under controlled conditions. Individual interpretation times for each case were recorded, and differences between groups determined.

Automated insufflation of carbon dioxide for MDCT colonography: distension and patient experience compared with manual insufflation.

Objective: The purpose of our study was to compare the effects of automated and manual carbon dioxide insufflation before CT colonography on distention and patient acceptance.

Subjects And Methods: One hundred forty-one symptomatic subjects underwent CT colonography using either an automated device (n = 47) or a manual method (n = 94) for carbon dioxide insufflation. CT data sets were assessed retrospectively in consensus by two blinded observers who graded distention for six colonic segments using a 4-point scale.

CT colonography in the detection of colorectal polyps and cancer: systematic review, meta-analysis, and proposed minimum data set for study level reporting.

Purpose: To assess the methodologic quality of available data in published reports of computed tomographic (CT) colonography by performing systematic review and meta-analysis.

Materials And Methods: The MEDLINE database was searched for colonography reports published between 1994 and 2003, without language restriction. The terms colonography, colography, CT colonoscopy, CT pneumocolon, virtual colonoscopy, and virtual endoscopy were used.

The role of CT colonography in colorectal cancer screening.

Computed tomographic colonography (CTC) is a relatively noninvasive technique for large bowel imaging that has the ability to detect colorectal neoplasia. Already well established as a reliable diagnostic tool in symptomatic patients who are unable to undergo complete colonoscopy, it is now being considered as a viable method for population screening. Advances in technique over the past 10 yr make this an attractive alternative, including reduced bowel preparation and stool tagging, three-dimensional (3D) image reconstruction, computer-aided detection software, and low-radiation dose protocols.

Quantitative assessment of colorectal cancer perfusion using MDCT: inter- and intraobserver agreement.

Objective: The objective of our study was to determine inter- and intraobserver agreement of MDCT colorectal cancer perfusion measurements.

Subjects And Methods: Thirty-one patients (17 men, 14 women; median age, 69 years) with proven colorectal cancer were examined prospectively using MDCT. A 65-sec dynamic study (cine mode, 4 x 5 mm collimation) was acquired through the tumor after i.

Experimental model of fistula-in-ano.

Purpose: This study was designed to create and evaluate an experimental porcine model of fistula-in-ano.

Methods: Initial cadaveric dissection enabled refinement of the technique for fistula formation and histoanatomical study of the porcine anal canal. Subsequently, three surgically created fistulas were treated by seton drainage in each of eight male pigs (weight, 38-41 kg).

Pilot study: fibrin sealant in anal fistula model.

Purpose: The aim of this study was to investigate the failure of fibrin sealant treatment for fistula-in-ano in an experimental porcine model and to determine histologic changes associated with the sealant and setons.

Methods: Three surgically created fistulas were treated by seton drainage in each of eight male pigs. After 26 days, magnetic resonance imaging was performed and setons were removed.

Value of hydrogen peroxide enhancement of three-dimensional endoanal ultrasound in fistula-in-ano.

Purpose: The aim of this prospective study was to compare the accuracy of three-dimensional endoanal ultrasound with that of hydrogen peroxide enhanced three-dimensional endoanal ultrasound in diagnosing recurrent or complex fistula-in-ano.

Methods: Three-dimensional endoanal ultrasound reconstructions were performed before and after hydrogen peroxide enhancement in 19 patients with suspected recurrent or complex fistula-in-ano. Two experienced observers derived a consensus fistula classification after a blinded random review of the data sets.

Quantitative colorectal cancer perfusion measurement using dynamic contrast-enhanced multidetector-row computed tomography: effect of acquisition time and implications for protocols.

Objective: To determine the effect of acquisition time on quantitative colorectal cancer perfusion measurement.

Methods: Dynamic contrast-enhanced computed tomography (CT) was performed prospectively in 10 patients with histologically proven colorectal cancer using 4-detector row CT (Lightspeed Plus; GE Healthcare Technologies, Waukesha, WI). Tumor blood flow, blood volume, mean transit time, and permeability were assessed for 3 acquisition times (45, 65, and 130 seconds).

A novel technique to measure splanchnic transit time using microbubble ultrasound.

Objective: The objective of this study was to measure splanchnic transit time by intravenous injection of a microbubble.

Materials And Methods: Ten volunteers were examined before and after eating. After Doppler indices of splanchnic circulation were obtained, the superior mesenteric artery (SMA) and vein (SMV) were simultaneously interrogated using power Doppler ultrasound after intravenous injection of a microbubble.

Clinical examination, endosonography, and MR imaging in preoperative assessment of fistula in ano: comparison with outcome-based reference standard.

Purpose: To prospectively evaluate the relative accuracy of digital examination, anal endosonography, and magnetic resonance (MR) imaging for preoperative assessment of fistula in ano by comparison to an outcome-derived reference standard.

Materials And Methods: Ethical committee approval and informed consent were obtained. A total of 104 patients who were suspected of having fistula in ano underwent preoperative digital examination, 10-MHz anal endosonography, and body-coil MR imaging.

MRI of fistula in ano: inter- and intraobserver agreement and effects of directed education.

Objective: Preoperative MRI of fistula in ano is becoming more common. This prospective study aimed to determine if a significant difference occurred in interpretation between one expert and one novice observer and to assess inter- and intraobserver agreement after both observers underwent a period of directed education. SUBJECTS AND METHODS.