我们旨在评估经会阴超声(TPUS)诊断直肠前突的有效性,直肠肠套叠(RI),肠膨出,会阴下降(PD),中国女性排便障碍综合征(ODS)和膀胱膨出,并通过TPUS确定直肠前突的分级。2019年1月至2021年12月,107例排便梗阻综合征患者,平均年龄49.76岁,接受TPUS和排便直肠造影(DEP)。两种方法均用于诊断肛门直肠角,直肠膨出,RI,肠膨出,还有PD,而膀胱膨出和子宫脱垂仅通过TPUS诊断。使用Cohenkappa统计比较DEP和TPUS诊断结果之间的一致性。DEP后报告了76例直肠前突,TPUS后报告了72例。DEP检测到7个小肠囊肿,其中6例通过TPUS同时诊断。43例患者在DEP时出现协同排便障碍(DD),而51在TPUS上。DEP和TPUS分别检测到13例和11例患者的PD,和RI分别在82和73中。直肠(kappa=0.738),RI(kappa=0.711),DD(kappa=0.774),肠膨出(kappa=0.847),和PD(kappa=0.625)通过Cohenkappa统计获得,这表明DEP和TPUS之间有很好的协议。TPUS诊断中度和重度直肠前突的临界值为12.05mm(AUC:0.941)和18.50mm(AUC:0.977),分别。在静息状态和Valsalva状态下,DEP确定和TPUS确定的肛门直肠角度显着相关(P<0.01)。与DEP相比,在保持直肠前突检测的良好一致性的同时,RI,DD,肠膨出,还有PD,TPUS是一种可重复且无创的替代方案。TPUS的阈值为12.05mm和18.50mm可诊断为中度和重度直肠前突,分别。
We aimed to evaluate the effectiveness of transperineal ultrasound (TPUS) in diagnosing rectocele, rectal intussusception (RI), enterocele, perineal descent (PD), and cystocele in Chinese women with obstructed
defecation syndrome (ODS), and to determine the grading of rectocele via TPUS. Between January 2019 and December 2021, 107 obstructed
defecation syndrome patients, with a mean age of 49.76 years, received TPUS and
defecation proctography (DEP). Both methods were used to diagnose anorectal angle, rectocele, RI, enterocele, and PD, while cystocele and uterine prolapse were diagnosed only through TPUS. Agreement between DEP and TPUS diagnostic results was compared using Cohen kappa statistics. Seventy-six rectoceles were reported following DEP and 72 after TPUS. DEP detected 7 enteroceles, 6 of which were diagnosed simultaneously by TPUS. 43 patients presented dyssynergic
defecation (DD) upon DEP, while 51 upon TPUS. DEP and TPUS detected PD in 13 and 11 patients respectively, and RI in 82 and 73, respectively. Rectocele (kappa = 0.738), RI (kappa = 0.711), DD (kappa = 0.774), enterocele (kappa = 0.847), and PD (kappa = 0.625) were obtained by Cohen kappa statistics, which indicated a good agreement between DEP and TPUS. The cutoff values for the diagnosis of moderate and severe rectocele with TPUS were 12.05 mm (AUC: 0.941) and 18.50 mm (AUC: 0.977), respectively. The DEP-determined and TPUS-determined anorectal angles were significantly correlated in the resting and Valsalva states (P < .01). Compared with DEP, while maintaining good agreement in detecting rectocele, RI, DD, enterocele, and PD, TPUS is a repeatable and noninvasive alternative. Threshold values of 12.05 mm and 18.50 mm on TPUS may diagnose moderate and severe rectocele, respectively.