Establishing a novel method for assessing elasticity of internal anal sphincter using ultrasonic real‐time tissue elastography

Fukui, Risa; Sasaki, Kazuhito; Kawai, Kazushige; Taira, Tetsuro; Nozawa, Hiroaki; Kaneko, Manabu; Murono, Koji; Emoto, Shigenobu; Iida, Yuuki; Ishii, Hiroaki; Yokoyama, Yuichiro; Anzai, Hiroyuki; Sonoda, Hirofumi; Ishihara, Soichiro

doi:10.1111/ans.16760

Cited by 1 publication

(2 citation statements)

References 38 publications

(46 reference statements)

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“…RTE was performed on each patient with freehand manual compression in the anterior, left, posterior, and right positions to confirm that the IAS was well-detected and its elasticity could be assessed. Fukui et al RTE method was followed [13], and IAS elasticity-the stiffness of the IAS at 6 o'clock of the anus-was recorded and evaluated (hardest (0) to softest (255), decrease in elasticity means sclerotic change). Figure 2b presents posterior IAS image evaluation.…”

Section: Real-time Tissue Elastographymentioning

confidence: 99%

“…Hence, we speculated that CRTinduced fibrosis may induce IAS sclerosis, which may consequently be associated with postoperative anal dysfunction. Therefore, in 2021, Fukui established a method to quantify IAS hardness and defined it as elasticity using real-time tissue elastography (RTE) on the endoanal ultrasonography (EAUS) [13]. Santoro et al have already reported that endorectal ultrasonography was useful in assessing the depth of submucosal invasion in early rectal cancer [14], but there are no reports of its use in functional assessment so far.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of anorectal function using real-time tissue elastography before and after preoperative chemoradiotherapy

Sakamoto,

Sasaki,

Nozawa

et al. 2024

Int J Colorectal Dis

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Purpose This study aimed to clarify the relationship between changes in elasticity and anorectal function before and after chemoradiotherapy. Methods This is a single-center prospective cohort study (Department of Surgical Oncology, The University of Tokyo). We established a technique to quantify internal anal sphincter hardness as elasticity using transanal ultrasonography with real-time tissue elastography. Twenty-seven patients with post-chemoradiotherapy rectal cancer during 2019–2022 were included. Real-time tissue elastography with transanal ultrasonography was performed before and after chemoradiotherapy to measure internal anal sphincter hardness as “elasticity” (hardest (0) to softest (255); decreased elasticity indicated sclerotic changes). The relationship between the increase or decrease in elasticity pre- and post-chemoradiotherapy and the maximum resting pressure, maximum squeeze pressure, and Wexner score were the outcome measures. Results A decrease in elasticity was observed in 16/27 (59.3%) patients after chemoradiotherapy. Patients with and without elasticity decrease after chemoradiotherapy comprised the internal anal sphincter sclerosis and non-sclerosis groups, respectively. The maximum resting pressure post-chemoradiotherapy was significantly high in the internal anal sphincter sclerosis group (63.0 mmHg vs. 47.0 mmHg), and a majority had a worsening Wexner score (60.0% vs. 18.2%) compared with that of the non-sclerosis group. Decreasing elasticity (internal anal sphincter sclerosis) correlated with a higher maximum resting pressure (r = 0.36); no correlation was observed between the degree of elasticity change and maximum squeeze pressure. Conclusion Internal anal sphincter sclerosis due to chemoradiotherapy may correlate to anorectal dysfunction.

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Section: Real-time Tissue Elastographymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%