Fecal incontinence is a major medical and social problem. The most frequent cause is a pathologic condition of the anal sphincter. Endoanal magnetic resonance (MR) imaging allows detailed visualization of the normal anatomy and pathologic conditions of the anal sphincter. The hyperintense internal sphincter appears as a continuation of the smooth muscle of the rectum; the hypointense external sphincter surrounds the lower part of the internal sphincter. A sphincteric defect is seen as a discontinuity of the muscle ring. Scarring appears as a hypointense deformation of the normal pattern of the muscle layer. Two external sphincteric patterns may be misdiagnosed as defects: a posterior discontinuity (often seen in young male patients) and an anterior discontinuity (often seen in female patients). Atrophy of the external sphincter is easily detected on coronal MR images by comparing the thicknesses of all anal muscles. Endoanal MR imaging is superior to endoanal ultrasonography because of the multiplanar capability and higher inherent contrast resolution of the former. Use of endoanal MR imaging may lead to better selection of candidates for surgery and therefore better surgical results. Endoanal MR imaging is the most accurate technique for detection and characterization of sphincteric lesions and planning of optimal therapy.
Skin and bone both contain primarily type I collagen in connective tissue matrices and are assumed to be related due to this common organic constituent. The purpose of this study was to investigate whether skin thickness measurements by ultrasound (US) could be used for screening for low bone mass. In 94 healthy, white, non-smoking women, 1-3 years postmenopause, the thickness of the skin of the left upper arm and forearm was measured by ultrasound (US). These measurements were compared with values of bone mineral density (BMD) as measured by quantitative computed tomography (QCT) of the lumbar spine and quantitative video micro-densitometry (QMD) of the hand. The correlation found between US skin thickness measurements and BMD results was of low magnitude and not significant. It is concluded that US measurements of skin thickness cannot be used to screen early postmenopausal women for low bone mass.
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