Keywords:
Pelvic floor dysfunction, Defecography, MR, Pelvis, Abdomen
Authors:
G. Gatta1, G. Di Grezia2, A. Faggian3, N. L. Pizza4, F. Iasiello1, M. Tecame1, R. Grassi5, A. Rotondo6, S. Cappabianca7; 1Napoli/IT, 2Avellino/IT, 3Cardito (Na)/IT, 4Nola (NA)/IT, 5Napoli (NA)/IT, 6Naples (NA)/IT, 7Santa Maria Capua Vetere (CE)/IT
DOI:
10.1594/ecr2013/C-1996
Conclusion
SE-MR has been hampered by the closed architecture of conventional MR systems,
limiting the patient position to the horizontal plane.
With the advent of open-configuration MR systems,
MR defecography with the patient in the sitting position has become possible (1,2,3).
The use of this technique is limited by worldwide availability.
According with previous reports (4,5),
our results show that SE-MR resulted in an underestimation of the severity of all disorders.
In addition relevant abnormalities that was seen at UP-MR images (see fig.
1,
fig 2) were not missed at SE-MR imaging,
but two elytroceles were missed due to the inability to ensure an adequate straining effort in supine position.
Some authors report that performing the examination using a state of the art technique,
which means MR imaging at rest,
at maximal contraction of the anal sphincter (squeezing),
at straining,
and during defaecation is probably more important than patient position.
(6,7).
Although most of the abnormalities could be identified at both UP-MR and SE-MR imaging,
they were best demonstrated with the UP-MR examination.
Overall,
UP-MR was not superior to SE-MR for depicting clinically relevant findings,
but it depicted a greater degree of pelvic floor laxity and allows the assessment of elytrocele (7).