Normal anorectum: dynamic MR imaging anatomy.

Kruyt, R. H.; Delemarre, J. B. V. M.; Doornbos, Joost; Vogel, H.

doi:10.1148/radiology.179.1.2006269

Cited by 91 publications

(58 citation statements)

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“…The ARA (the angle between the central axis of the anal canal and the posterior wall of the distal part of the rectum) [19] was measured at rest and during straining. ARA changes between rest and straining were calculated as [(ARA at straining) -(ARA at rest)].…”

Section: Imaging Analysismentioning

confidence: 99%

MR defecography in patients with dyssynergic defecation: spectrum of imaging findings and diagnostic value

Reiner¹,

Tutuian²,

Solopova³

et al. 2011

BJR

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Objectives: We describe the spectrum of findings and the diagnostic value of MR defecography in patients referred with suspicion of dyssynergic defecation. Methods: 48 patients (34 females, 14 males; mean age 48 years) with constipation and clinically suspected dyssynergic defecation underwent MR defecography. Patients were divided into patients with dyssynergic defecation (n518) and constipated patients without dyssynergic defecation (control group, n530). MRIs were analysed for evacuation ability, time to initiate evacuation, time of evacuation, changes in the anorectal angle (ARA-change), presence of paradoxical sphincter contraction and presence of additional pelvic floor abnormalities. Sensitivity, specificity, positive and negative predictive values and accuracy for the diagnosis of dyssynergic defecation were calculated. Results: The most frequent finding was impaired evacuation, which was seen in 100% of patients with dyssynergic defecation and in 83% of the control group, yielding a sensitivity for MR defecography for the diagnosis of dyssynergic defecation of 100% (95% confidence interval (CI) 97-100%), but a specificity of only 23% (95% CI 7-40%). A lower sensitivity (50%; 95% CI 24-76%) and a high specificity (97%; 95% CI 89-100%) were seen with abnormal ARA-change. The sensitivity of paradoxical sphincter contraction was relatively high (83%; 95% CI 63-100%). A combined analysis of abnormal ARA-change and paradoxical sphincter contraction allowed for the detection of 94% (95% CI 81-100%) of the patients with dyssynergic defecation. Conclusion: MR defecography detects functional and structural abnormal findings in patients with clinically suspected dyssynergic defecation. Impaired evacuation is seen in patients with functional constipation owing to other pelvic floor abnormalities than dyssynergic defecation.

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Section: Imaging Analysismentioning

confidence: 99%

MR defecography in patients with dyssynergic defecation: spectrum of imaging findings and diagnostic value

Reiner¹,

Tutuian²,

Solopova³

et al. 2011

BJR

View full text Add to dashboard Cite

show abstract

“…Dynamic MR imaging allows to assess the three compartments at the same time and to observe their mutual relationship at rest and during straining. Other benefits are the absence of ionizing radiation and the excellent anatomical details of the soft tissue such as muscles and pelvic viscera [6,9,[17][18][19][20][21]. On the other hand, the costs of dynamic MR imaging are high as compared with the clinical investigation.…”

Section: Introductionmentioning

confidence: 99%

A systematic review of clinical studies on dynamic magnetic resonance imaging of pelvic organ prolapse: the use of reference lines and anatomical landmarks

et al. 2009

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Introduction and hypothesis The aim of our study was to provide a systematic literature review of clinical studies on pelvic organ prolapse staging with use of dynamic magnetic resonance (MR) imaging. Methods The databases EMBASE and PubMed were searched. Clinical studies were included in case they compared pelvic organ prolapse stages as assessed on dynamic MR imaging (using a reference line) with a standardized method of clinical prolapse staging. Results Ten studies were included, which made use of seven different reference lines in relation to a wide variety of anatomical landmarks. Conclusions Only few studies have compared pelvic organ prolapse stages as assessed by dynamic MR imaging and clinical examination in a standardized manner. The available evidence suggests that prolapse assessment on dynamic MR imaging may be useful in the posterior compartment, but clinical assessment and dynamic MR imaging seem interchangeable in the anterior and central compartment.

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“…Use of the dMRI was first reported by Yang et al [26] and Kruyt et al [27]. dMRI is useful in detecting the movement of bladder, vagina, uterus and rectum in relation to the PCL and symphysiosacral line.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Effectiveness of Dynamic Colpocystoproctography in Women Planning for Combined Surgery with Urinary Incontinence and Pelvic Organ Prolapse

Kim

Park

Yi³

et al. 2014

Gynecol Obstet Invest

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Objective: To evaluate the advantage of performing the dynamic cystoproctography (DCP) in patients planning for combined surgery due to urinary incontinence and pelvic organ prolapse (POP). Materials and Methods: We performed DCP on a total of 113 consecutive women with POP and compared the findings of the physical examination with POP quantification against those of DCP including squeezing, straining and evacuation phases, and analyzed the changes to the rates of surgical planning. For statistical analysis, sensitivity, specificity, and positive predictive value of each test were performed. Results: DCP identified an additional 10 cases of cystocele, 32 cases of rectocele, 2 cases of enterocele, 4 cases of sigmoidocele, and 8 cases of rectal intussusception compared to those cases who were only included for a physical examination.The initial surgical plan was changed in a total of 24 cases (22.1%). The prevalence of bowel symptoms in the group in which the surgical plan changed was higher than in the group with no changes to the surgical plan (p = 0.023). Conclusions: DCP may be a more sensitive test for diagnosing POP compared to physical examination alone, and it is useful to patients with bowel symptoms by making surgical planning for combined surgery with stress urinary incontinence and POP.

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Normal anorectum: dynamic MR imaging anatomy.

Cited by 91 publications

References 0 publications

MR defecography in patients with dyssynergic defecation: spectrum of imaging findings and diagnostic value

MR defecography in patients with dyssynergic defecation: spectrum of imaging findings and diagnostic value

A systematic review of clinical studies on dynamic magnetic resonance imaging of pelvic organ prolapse: the use of reference lines and anatomical landmarks

Diagnostic Effectiveness of Dynamic Colpocystoproctography in Women Planning for Combined Surgery with Urinary Incontinence and Pelvic Organ Prolapse

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