역행성 치직장근 수축증의 진단에 근전도, 영상 배변 조영술 및 대장 지연성 운동 측정법의 유용성 = Correlation of Electromyography, Cinedefecography, and Colonic Transit Study in the Diagnosis of Paradoxical Puborectalis Contraction

다국어 초록 (Multilingual Abstract)

There is no confirmative study in the diagnosis of paradoxical puborectalis contraction. Electromyography, cinedefecography, and colonic transit study are main tests used in the diagnosis of this disease. However, we don't know the positive probability of these tests. Therefore, the aim of this study was to assess the positive probability of each tests in the diagnosis of paradoxical puborectalis contraction.
Between 1991 and 1997, 412 patients were tested due to constipation. 142 patients were diagnosed as paradoxical puborectalis contraction by anorectal physiology tests such as electromyography, cinedefecography, and colonic transit study. We calculated positive probability rates of each tests, and also calculated double positive probability of tests, and then compared the significance of results.
Positive probability rates of three tests were 62.3% in electromyography, 38.0% in colonic transit study, and 74.8% in cinedefecography; these results were significant bye chi-square test(p〈0.01). Positive probability rate was significantly high in cinedefecography (p〈0.001), and significantly low in colonic transit study (p〈0.001), but no significant in electromyography (p=0.56). When electromyography was positive, double positive probability of cinedefecography was 63.9%, and colonic transit study 25% (p〈0.001). When colonic transit study was positive, double positive probability of cinedefecography was 66.7%, and electromyography 40.0% (p〈0.05). When cinedefecography was positive, double positive probability of electromyography was 52.7%, and colonic transit study 33.3%(p〈0.05). Only 6 patients (4.2%) showed triple positive probability rate.
Cinedefecography has the most probability rate in the diagnosis of paradoxical puborectalis contraction, and colonic transit study has the least probability. In paradoxical puborectalis contraction, when electromyography or colonic transit study is positive, it would be better confirm the result of cinedefecography, and when cinedefecography is positive, the result of electromyography is important. However, combination of these three tests is suggested in the diagnosis of paradoxical puborectalis contraction because of relatively suboptimal probability rates of these tests.