| Semi-automated vectorial analysis of anorectal motion by magnetic resonance defecography in healthy subjects and fecal incontinence. | |
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MedLine Citation:
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PMID: 22765510 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background Inter-observer variability limits the reproducibility of pelvic floor motion measured by magnetic resonance imaging (MRI). Our aim was to develop a semi-automated program measuring pelvic floor motion in a reproducible and refined manner. Methods Pelvic floor anatomy and motion during voluntary contraction (squeeze) and rectal evacuation were assessed by MRI in 64 women with fecal incontinence (FI) and 64 age-matched controls. A radiologist measured anorectal angles and anorectal junction motion. A semi-automated program did the same and also dissected anorectal motion into perpendicular vectors representing the puborectalis and other pelvic floor muscles, assessed the pubococcygeal angle, and evaluated pelvic rotation. Key Results Manual and semi-automated measurements of anorectal junction motion (r = 0.70; P < 0.0001) during squeeze and evacuation were correlated, as were anorectal angles at rest, squeeze, and evacuation; angle change during squeeze or evacuation was less so. Semi-automated measurements of anorectal and pelvic bony motion were also reproducible within subjects. During squeeze, puborectalis injury was associated (P ≤ 0.01) with smaller puborectalis but not pelvic floor motion vectors, reflecting impaired puborectalis function. The pubococcygeal angle, reflecting posterior pelvic floor motion, was smaller during squeeze and larger during evacuation. However, pubococcygeal angles and pelvic rotation during squeeze and evacuation did not differ significantly between FI and controls. Conclusion & Inferences This semi-automated program provides a reproducible, efficient, and refined analysis of pelvic floor motion by MRI. Puborectalis injury is independently associated with impaired motion of puborectalis, not other pelvic floor muscles in controls and women with FI. |
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Authors:
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J Noelting; A E Bharucha; D S Lake; A Manduca; J G Fletcher; S J Riederer; L Joseph Melton; A R Zinsmeister |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-7-6 |
Journal Detail:
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Title: Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society Volume: - ISSN: 1365-2982 ISO Abbreviation: - Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-7-6 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9432572 Medline TA: Neurogastroenterol Motil Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2012 Blackwell Publishing Ltd. |
Affiliation:
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Division of Gastroenterology and Hepatology, College of Medicine, Mayo Clinic, Rochester, MN, USA Department of Physiology and Biomedical Engineering, College of Medicine, Mayo Clinic, Rochester, MN, USA Department of Radiology, College of Medicine, Mayo Clinic, Rochester, MN, USA Divisions of Epidemiology, College of Medicine, Mayo Clinic, Rochester, MN, USA Biomedical Statistics and Informatics, College of Medicine, Mayo Clinic, Rochester, MN, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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