High‐frequency ultrasound imaging of the anal sphincter muscles in normal subjects and patients with fecal incontinence
| Autor: | Melissa M. Ledgerwood-Lee, David C. Kunkel, Ali Zifan, Robert L. Sah, Ravinder K. Mittal |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Physiology External anal sphincter Clinical Sciences Medical Physiology Anal Canal Connective tissue Bioengineering Perineum Article 03 medical and health sciences 0302 clinical medicine 80 and over medicine Humans Fecal incontinence Ultrasonography Aged Aged 80 and over screening and diagnosis Gastroenterology & Hepatology Endocrine and Autonomic Systems business.industry Ultrasound Neurosciences Gastroenterology Anatomy Middle Aged Anal canal 4.1 Discovery and preclinical testing of markers and technologies Detection medicine.anatomical_structure 030220 oncology & carcinogenesis Biomedical Imaging Sphincter Female 030211 gastroenterology & hepatology medicine.symptom Digestive Diseases business Anal sphincter Muscle architecture Fecal Incontinence |
| Zdroj: | Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society, vol 31, iss 4 |
| ISSN: | 1365-2982 1350-1925 |
| Popis: | IntroductionThe current "gold standard" to diagnose anal sphincter morphology and disruptions utilizes low-frequency (3-9MHz) ultrasound (US) imaging techniques that provide a general outline of the sphincter muscles, but not their microstructural details. High-frequency US transducers (7-15MHz) have been used to study the muscle architecture (direction of muscle fascicles) in the limb muscle.AimsThe goal of our study was to visualize the microstructural anatomy of the anal sphincters, specifically the external anal sphincter (EAS), using high-frequency US imaging.MethodsStudies were conducted in asymptomatic female and male subjects and patients with fecal incontinence. US images were acquired using a low-frequency US (3-9MHz) and high-frequency (7-15MHz) US transducer. The latter was placed intra-anally to image the anal canal at 12, 9, 3, and 6 o'clock positions.ResultsThe low-frequency US images revealed the general outline of the anal sphincter muscles. On the other hand, high-frequency imaging visualized muscle fascicles and connective tissue inside the external anal sphincter (EAS). In FI patients, there was loss of muscle fascicles and alteration in the echo-intensity pattern in the region of damaged EAS suggestive of muscle fibrosis.ConclusionHigh-frequency ultrasound imaging is a powerful tool to visualize the microstructural details of the EAS. Our studies show that damage to the EAS muscle results in the alteration of its myoarchitecture, that is, loss of muscle fascicles and increase in the muscle connective tissue. |
| Databáze: | OpenAIRE |
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