| Dynamic magnetic resonance imaging defecography: a diagnostic alternative in the assessment of pelvic floor disorders in proctology. | |
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MedLine Citation:
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PMID: 11496081 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Standard diagnostic proctologic procedures in the assessment of pelvic floor disorders include clinical evaluation and endoscopy. Particular aspects of combined pelvic floor disorders, especially those involving more than one pelvic compartment, may remain undetected without additional technical diagnostic procedures such as videoproctoscopy, cinedefecography, or colpocystodefecography. The aim of the study was to review the potentials of dynamic magnetic resonance imaging defecography to elucidate the underlying anatomic and pathophysiologic background of pelvic floor disorders in proctologic patients. PATIENTS AND METHODS: Dynamic magnetic resonance imaging defecography was performed in 20 Patients (13 females) with main diagnoses such as rectal prolapse or intussusception, rectocele, descending perineum, fecal incontinence, outlet obstruction, and dyskinetic puborectalis muscle after clinical evaluation. The investigation was performed on a 1.5 T-magnetic resonance imaging machine in supine position. The rectum was filled with Gd-DTPA enriched ultrasound gel. First a T1/T2 weighted investigation of the pelvis was performed, followed by defecography with evacuation of the rectum. Images were obtained in a sagittal plane in a frequency of 1 image/second (true FISP) at rest and during straining. The obtained magnetic resonance imaging video tapes were analyzed off-line with cinematographic evaluation of bladder base, uterus, and anal canal position in relation to the pubococcygeal line by a blinded radiologist. Investigation time was 20 minutes. RESULTS: In dynamic magnetic resonance imaging defecography of the pelvic floor, 12 patients with descending perineum, 10 rectoceles (10 females), 6 cystoceles (6 females), 4 enteroceles (4 females), 8 intussusceptions (5 females), and a dyskinetic puborectalis muscle in 3 males were detected. In 11 females and 3 males multifocal disorders were found, involving more than one compartment in females, whereas in males complex defects were restricted to the posterior compartment. Magnetic resonance imaging defecography revealed diagnoses consistent with clinical results in 77.3 percent and defects in addition to clinical diagnoses in combined pelvic floor disorders in 34 percent. CONCLUSIONS: In complex pelvic floor disorders, involving more than a single defect, dynamic magnetic resonance imaging represents a convenient diagnostic procedure in females and to a lesser extent in males, in particular in terms of dynamic imaging of pelvic floor organs during defecation. In addition to the clinical assessment, dynamic magnetic resonance imaging had clinical impact in proctologic and interdisciplinary treatment. |
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Authors:
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M Rentsch; C Paetzel; M Lenhart; S Feuerbach; K W Jauch; A Fürst |
Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Diseases of the colon and rectum Volume: 44 ISSN: 0012-3706 ISO Abbreviation: Dis. Colon Rectum Publication Date: 2001 Jul |
Date Detail:
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Created Date: 2001-08-09 Completed Date: 2001-08-23 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0372764 Medline TA: Dis Colon Rectum Country: United States |
Other Details:
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Languages: eng Pagination: 999-1007 Citation Subset: IM |
Affiliation:
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Department of Surgery, University of Regensburg, D-93042 Regensburg, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Defecation / physiology* Diagnosis, Differential Fecal Incontinence / diagnosis, pathology Female Humans Intestinal Obstruction / diagnosis, pathology Magnetic Resonance Imaging / methods* Male Middle Aged Pelvic Floor / pathology* Rectal Diseases / diagnosis, pathology* Rectal Prolapse / diagnosis, pathology Rectocele / diagnosis, pathology Sex Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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