High-resolution magnetic resonance imaging of the anorectal region without an endocoil

Beets‐Tan, Regina G. H.; Beets, Geerard L.; Hoop, A. Gerritsen van der; Borstlap, A. C. W.; Boven, Hester van; Rongen, M. J. G. M.; Baeten, C.G.; Engelshoven, Jos M. A. van

doi:10.1007/s002619900567

Cited by 53 publications

(34 citation statements)

References 24 publications

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“…Recent research has evaluated the role of high-resolution MRI of the anal sphincter using phased-array coils [27]. This study has demonstrated the potential value of this technique, but its role in anal incontinence has yet to be determined.…”

Section: Techniquementioning

confidence: 97%

Imaging of the posterior pelvic floor

2001

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Disorders of the posterior pelvic floor are relatively common. The role of imaging in this field is increasing, especially in constipation, prolapse and anal incontinence, and currently imaging is an integral part of the investigation of these pelvic floor disorders. Evacuation proctography provides both structural and functional information for rectal voiding and prolapse. Dynamic MRI may be a valuable alternative as the pelvic floor muscles are visualised, and it is currently under evaluation. Endoluminal imaging is important in the management of anal incontinence. Both endosonography and endoanal MRI can be used for detection of anal sphincter defects. Endoanal MRI has the advantage of simultaneously evaluating external sphincter atrophy, which is an important predictive factor for the outcome of sphincter repair. Many aspects of constipation and prolapse remain incompletely understood and treatment is partly empirical; however, imaging has a central role in management to place patients into treatment-defined groups.

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Section: Techniquementioning

confidence: 97%

Imaging of the posterior pelvic floor

2001

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“…L'endo-IRM [24,39,56,57] ou I'IRM externe en r6seau phas6 [58] semblent 6galement capables d'6valuer l'appareil sphinct6rien. Un d6fect apparalt comme une interruption de la continuit6 de l'anneau musculaire et une cicatrice fibreuse comme une zone en hyposignal [59][60][61].…”

Section: Evaluation De L'appareil Sphinct~rienunclassified

L’imagerie dans la maladie de Crohn anopérinéale

et al. 2000

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Imaging in anal Crohn's disease RI~SUMI~Longtemps considOrOe comme secondaire et peu contributive, l'imagerie en proctologie a beaucoup Ovolu6 ces dix derniOres ann6es et contribud ~ amdliorer la prise en charge des troubles de la continence anale et des suppurations anorectales. En particulier, l'Ochographie endocavitaire (EE) et l'imagerie par r6sonance magnOtique (IRM) prennent une place grandissante dans le cadre de la maladie de Crohn anopOrinOale (MAP). Elles ne sont pas indiqu6es de fagon systOmatique mais s'avOrent utiles voire indispensables dans les situations difficiles : suppuration complexe et/ou multi-opOr6e, retard de cieatrisation ou persistance d'un dcoulement postopdratoire, suspicion ou notion av6r6e de troubles de la continence, douleurs anorectales inexpliqu6es. L'IRM semble globalement plus fiable que I'EE dans le repOrage des orifices primaire(s) et secondaire(s), des trajets fistuleux et des collection(s). Cela prurient de sa meilleure rOsolution en contraste et de la possibilit6 d'une analyse tridimensionnelle sachant que de nombreuses amOliorations techniques runt encore amdliorer ses performances. Toutefois, I'EE est une technique fiable et bien codifi6e pour l'dvaluation de l'appareil sphinctdrien. En outre, elle prOsente l'avantage par rapport I'IRM d'etre facile d'acc~s, bun march6, de courte dur6e et simple ~ mettre en oeuvre. Finalement, ces deux techniques semblent eompl6men-takes mais, s'il faut choisir, faire appel ~ un radiologue ayant une excellente connaissance de l'anatomie anorectale et de la maladie de Crohn importe actuellement davantage que le choix de la technique. ABRI~VIATIONS : MAP : maladie de Crohn anop6rin6ale.EE : 6chographie endocavitaire. IRM : imagerie par r6sonance magndtique. SUMMARY Considered for a long time as a secondary matter with little contribution of its own, imaging in proctology has much evolved during the last decade and has contributed to improve the management of faecal incontinence and anorectal sepsis. Especially, endosonography (ES) and magnetic resonance imaging (MRI) play an increasing role in the anoperineal forms of Crohn's disease (APCD). They are not systematically indicated but they turn out to be usefid and even indispensable in difficult situations: complex and~or multi-operated suppuration, healing delay or persistence of discharge after operation, suspicion or observation of faecal incontinence, unexplained anorectal pain. Overall MRI seems more reliable than ES in the detection of primary and secondary opening(s), fistulous pathways and collection(s). This results from better contrast resohttion and the possibility of tridimensional analysis, keeping in mind that numerous technical improvements will keep ameliorating its performances. ES, however, is a reliable and well codified technique for the evahmtion of sphincters. In addition, it has the advantage over MRI of being easy to access, cost-effective and fast and easy to perform. Finally, these two techniques seem to be complementary but, if one has to make a choice, selecting ...

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“…Further, MR imaging was recently found to have added value as compared with the clinical assessment of patients with perianal fistulas [20]. The results of these studies [2,3,5,19] in addition to the preliminary findings by Beets-Tan et al [1] suggest that MRI could serve as part of the preoperative assessment of anorectal diseases. The diagnostic information provided by MRI prior to any surgical procedure or during the postoperative follow-up may improve the clinical and surgical management in patients with anorectal diseases S. M. Hussain and E. K. Outwater: MRI of the anorectal region 583 and may help to reduce the occurrence of complications.…”

mentioning

confidence: 91%

“…In this respect, the report by Beets-Tan et al in this issue of Abdominal Imaging is interesting [1]. Beets-Tan et al performed a feasibility study to assess the ability of the spine phased array coil in depicting the normal anatomy and abnormalities of the anorectal region.…”

mentioning

confidence: 95%

“…In relation to their article [1], there are a few points that need to be addressed. First, the use of phased array coils or external surface coils for pelvic abnormalities, including anorectal diseases, has been a common practice in many body MRI centers for a number of years [14,15], although previous studies have not specifically described the anatomy of the anal sphincters when using a phased array coil.…”

mentioning

confidence: 98%

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