Predictive value of impaired evacuation at proctography in diagnosing anismus.

Objective: We aimed to determine the positive predictive value of impaired evacuation during evacuation proctography for the subsequent diagnosis of anismus.

Subjects And Methods: Thirty-one adults with signs of impaired evacuation (defined as the inability to evacuate two thirds of a 120 mL contrast enema within 30 sec) during evacuation proctography underwent subsequent anorectal physiologic testing for anismus. A physiologic diagnosis of anismus was based on a typical clinical history of the condition combined with impaired rectal balloon expulsion or abnormal surface electromyogram.

Dose reduction in evacuation proctography.

The goal of this study was to reduce the patient radiation dose from evacuation proctography. Ninety-eight consecutive adult patients referred for proctography to investigate difficult rectal evacuation were studied using a digital imaging system with either a standard digital program for barium examinations, a reduced dose digital program (both with and without additional copper filtration), or Video fluoroscopy. Dose-area products were recorded for each examination and the groups were compared.

Transvaginal ultrasound examination of women with and without pelvic venous congestion.

Aim: To determine if transvaginal ultrasound, including power Doppler examination, can distinguish between women with and without pelvic congestion.

Materials And Methods: Thirty-six women with pelvic congestion were prospectively examined using transvaginal ultrasonography and standard uterine and ovarian measurements made. Additionally, planimetric measurements of each ovary were taken using an image analysis program to determine the cross-sectional area of ovarian stroma and follicles, if any.

Prospective assessment of interobserver agreement for endoanal MRI in fecal incontinence.

Background: Endoanal magnetic resonance (MR) imaging is a new technique for the assessment of anal sphincter integrity in fecal incontinence and an alternative to anal endosonography. The present study aimed to determine interobserver variation for assessment of anal sphincter integrity using endoanal MR imaging.

Methods: Fifty-two consecutive anally incontinent patients underwent MR imaging by using a purpose-built endoanal receiver coil and static 1.

Prospective assessment of accuracy of endoanal MR imaging and endosonography in patients with fecal incontinence.

Objective: Endoanal MR imaging was prospectively compared with anal endosonography to determine any superiority in the characterization of sphincter morphology in fecal incontinence.

Subjects And Methods: Fifty-two consecutive patients with fecal incontinence were examined with anal endosonography and endoanal MR imaging after a detailed bowel history, clinical examination, and complete anorectal physiologic testing. External and internal anal sphincter integrity was noted on both endosonograms and MR images by two radiologists in consensus, who read individual scans in a random order to avoid recall bias.

Cisapride or metoclopramide to accelerate small bowel transit during barium follow-through examination?

Background: Metoclopramide is commonly used to accelerate small bowel transit during barium follow-through (BaFT) examinations, but its action is unpredictable. Cisapride, commonly used to treat gastroesophageal reflux disease, also accelerates small bowel transit and may be a viable alternative. The two were compared in a prospective, randomized, blind study.

Dynamic MR imaging of the pelvic floor in asymptomatic subjects.

Objective: Dynamic MR imaging may be used as an alternative to dynamic cystoproctography for the evaluation of pelvic floor prolapse and configuration. MR criteria for normality are derived from proctographic studies because no large MR study of asymptomatic individuals has been performed. Our study aimed to define the normal range of dynamic pelvic MR appearances in a large group of asymptomatic individuals.

Changes in anal anatomy following vaginal delivery revealed by anal endosonography.

Objective: To investigate changes in anal canal anatomy following vaginal delivery in women without apparent sphincter injury.

Design: Prospective controlled observational study.

Setting: District general hospital.

Intraobserver and interobserver agreement in anal endosonography.

Background: The aim of this study was to determine intraobserver and interobserver agreement for sonographic measurements of anal canal structures using anal endosonography (AES), and to determine interobserver agreement for the diagnosis of anal sphincter disruption.

Methods: Fifty-one consecutive patients referred for AES for the investigation of possible sphincter abnormality were examined. Studies were reviewed by two observers who measured anal canal structures at defined levels and locations, and recorded an opinion on sphincter integrity.

Evacuation proctography: a prospective study of diagnostic and therapeutic effects.

Purpose: To determine the diagnostic and therapeutic effects of evacuation proctography.

Materials And Methods: Forty-seven referring clinicians completed preevacuation proctography questionnaires for 50 patients, detailing diagnoses, confidence in these, intended management, and what they hoped to learn. After evacuation proctography, the radiology report was returned with a second questionnaire asking the diagnosis in the light of evacuation proctographic findings, their confidence, and what they had learned.

MR imaging of fistula in ano: are endoanal coils the gold standard?

Objective: It has been suggested that fistula in ano is most accurately assessed using endoanal receiver coils because they provide superior spatial resolution. We aimed to determine their advantage by prospective comparison with conventional body coil imaging.

Subjects And Methods: Thirty consecutive unselected patients with a diagnosis of anorectal sepsis were examined by MR imaging with an endoanal coil.

Magnetic resonance imaging of fistula-in-ano: STIR or SPIR?

Patients with clinically suspected anorectal sepsis were studied using MRI in order to determine if T2 weighted sequences with fat suppression conveyed any additional benefit over conventional short tau inversion recovery (STIR) sequences. 23 consecutive patients (16 male) undergoing MRI for suspected perianal sepsis were studied prospectively using a 1.0 T whole body system and body coil.

Adult Crohn disease: can ileoscopy replace small bowel radiology?

Background: This study aimed to document the radiological features and distribution of small bowel Crohn disease (CD) in adults by using a barium follow-through (BaFT) technique and to determine whether disease would be missed or its distribution underestimated if only colonoscopy with ileoscopy were performed.

Methods: The BaFT examinations of 121 adults with proven CD were reviewed retrospectively with respect to the stage and distribution of disease. Colonoscopy with attempted ileoscopy was performed in 37 of these subjects, and the results were compared with radiological findings.