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2010 | 82 | 9 | 515-519
Tytuł artykułu

Does the use of 3D Endoanal Ultrasound Improve Inter-Observer Agreement Compared with 2D Ultrasound in Patients with Faecal Incontinence?

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Endoanal ultrasound (EAUS) is used in the assessment of the anal sphincter in patients with faecal incontinence. However, interpretation is very operator dependent. 3D technology allows capture of the image of the whole anal canal in three dimensions and manipulation of the image by others not carrying out the scan reducing operator dependence.The aim of the study was to determine whether inter-observer agreement is better using 3D technology compared with 2D images.Material and methods. For the first part of the study inter-observer variability was compared using a small number of patients and a large number of interpreters. Study images of ten randomly selected patients undergoing endoanal ultrasound for faecal incontinence were obtained in 2D format and using 3D technology. Images were interpreted by 4 specialists (defined as personnel who regularly reported scans) and 9 non-specialists with an interest in coloproctology (1 radiologist and 8 colorectal surgeons). For the second part of the study images of forty patients were randomly selected in both formats and interpreted by only 2 specialists. Each image was graded as normal, showing internal sphincter injury, external sphincter injury or a combination.Results. There appeared to be minimal to no advantage for the 3D format over the 2D format for any of the groups in terms of inter-observer variability. For interpretation of the 10 images as expected the inter-observer agreement was low for the non-specialist group (k = 0.11 for 2D and k = 0.16 for 3D) but was surprisingly only moderate for the specialists alone (k = 0.42 for 2D and k = 0.44 for 3D). In the second part of the study there was a higher overall agreement and a slight improvement in interobserver variability with the 3D format. Agreement was moderate for 2D and substantial for 3D (k = 0.60 and k = 0.67 respectively).Conclusions. Despite the ability to view the whole anal canal in different planes, the 3D technology appears to only slightly improve inter-observer agreement and only in expert hands.
Słowa kluczowe
Wydawca
Rocznik
Tom
82
Numer
9
Strony
515-519
Opis fizyczny
Daty
wydano
2010-09-01
online
2010-10-22
Twórcy
autor
  • Sheffield Teaching Hospitals NHS, Foundation Trust Northern General Hospital, Herries Road, Sheffield, S7 5AU, United Kingdom
autor
  • Sheffield Teaching Hospitals NHS, Foundation Trust Northern General Hospital, Herries Road, Sheffield, S7 5AU, United Kingdom
Bibliografia
  • Christensen AF, Nyhuus B, Nielsen MB et al.: Three-dimensional anal endosonography may improve diagnostic confidence of detecting damage to the anal sphincter complex. Br J Radiol 2005; 78: 308-11.[PubMed]
  • Fleiss JL: Measuring nominal scale agreement among many raters. Psychological Bulletin 1971; 76: 378-82.
  • Landis JR, Koch GG: The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159-74.[PubMed]
  • Randolph, J. J 2008. Online Kappa Calculator. From
  • Sultan AH, Kamm MA, Talbot IC et al.: Anal endosonography for identifying external sphincterdefects confirmed histologically. Br J Surg 1994; 81: 463-65.
  • Sultan AH, Nicholls RJ, Kamm MA et al.: Anal endosonography and correlation with in vitro and in vivo anatomy. Br J Surg 1993; 80: 508-11.
  • Sultan AH, Kamm MA, Hudson CN et al.: Analsphincter disruption during vaginal delivery. N Engl J Med 1993; 329: 1905-11.
  • Malouf AJ, Williams AB, Halligan S et al.: Prospective assessment of accuracy of endoanal MR imaging and endosonography in patients with fecal incontinence. Am J Roentgenol 2000; 175: 741-45.
  • de Leeuw JW, Vierhout ME, Struijk PC et al.: Anal sphincter damage after vaginal delivery: relationship of anal endosonography and manometry to anorectal complaints. Dis Colon Rectum 2002; 45: 1004-10.
  • Bartram C: Anal endosonography after sphincter repair. Abdom Imaging 1999; 24: 574-75.[PubMed]
  • Boyle DJ, Knowles CH, Lunniss PJ et al.: Efficacy of sacral nerve stimulation for fecal incontinence in patients with anal sphincter defects. Dis Colon Rectum 2009; 52(7): 1234-39.[PubMed][Crossref]
  • Faltin DL, Boulvain M, Stan C et al.: Intraobserver and interobserver agreement in the diagnosis of anal sphincter tears by postpartum endosonography. Ultrasound Obstet Gynaecol 2003; 21: 375-77.
  • Norderval S, Dehli T, Vonen B: Three-dimensional endoanal ultrasonography: intraobserver and interobserver agreement using scoring systems for classification of anal sphincter defects. Ultrasound Obstet Gynaecol 2009; 33: 337-43.
  • Gold DM, Halligan S, Kmiot WA et al.: Intraobserver and interobserver agreement in anal endosonography. Br J Surg 1999; 86: 371-75.
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_v10035-010-0075-0
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