La defecografia nella diagnosi di incontinenza fecale: Analisi delle Receiver Operating Characteristic (ROC)

Translated title of the contribution: The role of defecography in the diagnosis of fecal incontinence: Receiver Operating Characteristic (ROC) analysis

Vittorio Piloni, Rosaria Gesuita, Paola Fioravanti, Liana Spazzafumo

Research output: Contribution to journalArticle

Abstract

Two groups of patients with altered bowel habit and pelvic floor dysfunction, but comparable epidemiologic characteristics (i.e. n = 105 each; mean age and SD 47.3 ± 15.8 yrs vs. 54.9 ±1 6.7 yrs; range 15-80 yrs vs. 9-88 yrs; F/M ratio 28 : 1 vs. 2.6 : 1) with the exception of the absence (or presence) of fecal incontinence, were examined with defecography, taking into account criteria other than anorectal angle values and anorectal junction mobility. At the Receiver Operating Characteristic (ROC) analysis a «barium leak sign», occurring either at rest or on straining was found to be a highly reliable index of fecal incontinence (specificity: 100% and 92-93%, respectively, intraobserver agreement K value = 0.82, Z = 21.58, p <0.001). A false negative rate of 14.2% was limited to «minor» incontinence only, i.e., incontinence to gas and/or occasional staining episodes. In the search for an etiologic diagnosis, useful adjunctive criteria included (a) anal diameter > 10 mm at rest; (b) poor stop test (inability to interrupt the barium stream); (c) rectal diameter > 6.5 cm and <4 cm (abnormally increased and reduced compliance, respectively). Defecography is a useful diagnostic tool in fecal incontinence and should precede anal endosonography, manometry and electromyography for proper therapeutic decision-making and in risk conditions, e.g., in the patients about to undergo elective pelvic surgery.

Original languageItalian
Pages (from-to)73-80
Number of pages8
JournalRadiologia Medica
Volume91
Issue number1-2
Publication statusPublished - Jan 1996

    Fingerprint

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Piloni, V., Gesuita, R., Fioravanti, P., & Spazzafumo, L. (1996). La defecografia nella diagnosi di incontinenza fecale: Analisi delle Receiver Operating Characteristic (ROC). Radiologia Medica, 91(1-2), 73-80.