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Prospective Assessment of Accuracy of Endoanal MR Imaging and Endosonography in Patients with Fecal Incontinence

Andrew J. Malouf1,2, Andrew B. Williams1, Steve Halligan1, Clive I. Bartram1, Sukvinder Dhillon1 and Michael A. Kamm2

1 Intestinal Imaging Centre, St. Mark's Hospital, Northwick Park, Watford Road, Harrow, Middlesex, HA1 3UJ, United Kingdom.
2 Sir Alan Parks Physiology Unit, St. Mark's Hospital, Northwick Park, London, HA1 3UJ, United Kingdom.



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  		Fig. 1A. —47-year-old woman with anal incontinence caused by functional disorder. Anal endosonogram shows intact external (curved arrows) and internal (straight arrow) anal sphincters. Anterior is uppermost.

 


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  		Fig. 1B. —47-year-old woman with anal incontinence caused by functional disorder. T2-weighted endoanal MR image also shows intact external (black arrow) and internal (white arrow) anal sphincters.

 


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  		Fig. 2A. —57-year-old woman with incontinence after anal surgery for hemorrhoids. Anal endosonogram shows internal sphincter defect between 10-and 3-o'clock positions (arrows).

 


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  		Fig. 2B. —57-year-old woman with incontinence after anal surgery for hemorrhoids. T2-weighted endoanal MR image shows internal sphincter to be intact (arrow).

 


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  		Fig. 3A. —60-year-old man with incontinence after surgery for fistula in ano. Anal endosonogram shows internal sphincter defect, with general fragmentation of sphincter. Straight arrows indicate sphincter remnants. External sphincter defect in right posterior quadrant was also visualized (curved arrow).

 


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  		Fig. 3B. —60-year-old man with incontinence after surgery for fistula in ano. T2-weighted endoanal MR image at level corresponding to A also shows internal sphincter fragments (straight arrows). External sphincter was shown to be intact (curved arrow).

 

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