Role of conventional radiology and MRi defecography of pelvic floor hernias

Reginelli, Alfonso; Grezia, Graziella Di; Gatta, Gianluca; Iacobellis, Francesca; Rossi, Cláudia; Giganti, Melchiore; Coppolino, Francesco; Brunese, Luca

doi:10.1186/1471-2482-13-s2-s53

Cited by 22 publications

(6 citation statements)

References 36 publications

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“…Some authors reported that to perform the examination using a state-of-the-art technique, which means dynamic MR imaging in supine position in closed magnet at rest, during squeezing, straining, and evacuation is probably more important than to consider the patient position [ 11 , 17 , 40 , 41 ]. In our previous experience, imaging the patients in supine position has been shown to be satisfactory in the evaluation of symptomatic pelvic floor weakness even if defects are best demonstrated when patients are sitting [ 42 , 43 ]. According to this, the results of the present study show that a statistically significant difference exists when the pelvic floor descent is evaluated in sitting versus supine position, and the MR study in supine position can underestimate the fixed descent (Figures 2 , 3 , and 4 ).…”

Section: Discussionmentioning

confidence: 99%

MR Imaging in Diagnosis of Pelvic Floor Descent: Supine versus Sitting Position

Iacobellis

Brillantino²,

Renzi³

et al. 2016

Gastroenterology Research and Practice

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Introduction. Functional disorders of the pelvic floor represent have a significant impact on the quality of life. The advent of open-configuration systems allowed for the evaluation of defecation with MR imaging in sitting position. The purpose of the present study is to compare the results of static and dynamic pelvic MR performed in supine position versus sitting position, using a new MR prototype machine, in the diagnosis of pelvic floor descent. Materials and Methods. Thirty-one patients with pelvic floor disorders were enrolled, and underwent MR Defecography in supine position with 1.5 T closed magnet (MAGNETOM Symphony, Siemens, Germany) and in sitting position with a 0.25-Tesla open magnet system (G-Scan ESAOTE, Italy). Results. In rest and squeezing phases, positions of bladder, vagina, and ARJ were significantly different when the patient was imaged in supine versus sitting position. In the defecation phase, a significant difference for the bladder and vagina position was detected between the two exams whereas a significant difference for the ARJ was not found. A statistically significant difference exists when the pelvic floor descent is evaluated in sitting versus supine position. Conclusion. Our results show that MR Defecography in sitting position may represent a useful tool to correctly diagnose and grade the pelvic organ descent.

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Section: Discussionmentioning

confidence: 99%

MR Imaging in Diagnosis of Pelvic Floor Descent: Supine versus Sitting Position

Iacobellis

Brillantino²,

Renzi³

et al. 2016

Gastroenterology Research and Practice

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“…The main limitations of our study were the small number of patients and the lack of postoperative anal ultrasound and anorectal manometry studies in patients with a more caudal peritoneal reflection, which could have provided not only topographic but also functional and anorectal anatomy information. Nevertheless, our findings provide further evidence that obesity and parity are anatomical risk factors for pelvic floor dysfunction that affect the location of the peritoneal reflection, concurrently with advanced age, estrogen deficiency, diabetes mellitus, pelvic radiotherapy, and orifice surgery, [24][25][26][27] although we found no significant correlations between the length of the peritoneal reflection and classical risk factors associated with the location of this important surgical anatomical landmark, such as female gender and patient height. Moreover, and importantly, we used a standardized protocol in living patients rather than in cadavers, unlike most anatomy studies.…”

Section: Discussionmentioning

confidence: 88%

Is There a Precise Correlation between the Lengths of the Peritoneal Reflection and the Middle Rectal Valve?

Neto

Oliveira

Robles

et al. 2022

Journal of Coloproctology

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Introduction Pelvic anatomy remains a challenge, and thorough knowledge of its intricate landmarks has major clinical and surgical implications in several medical specialties. The peritoneal reflection is an important landmark in intraluminal surgery, rectal trauma, impalement, and rectal adenocarcinoma. Objectives To investigate the correlation between the lengths of the middle rectal valve and of the peritoneal reflection determined with rigid sigmoidoscopy and to determine whether there are any differences in the location of the peritoneal reflection between the genders and in relation to body mass index (BMI) and parity. Design We prospectively investigated the location of the middle rectal valve and of the peritoneal reflection via intraoperative rigid sigmoidoscopy in colorectal cancer patients undergoing elective colorectal surgery. Results We evaluated 38 patients with a mean age of 55.5 years old (57.5% males) who underwent colorectal surgery at the coloproctology service of the Hospital Santa Marcelina, São Paulo, state of São Paulo, Brazil. There was substantial agreement between the lengths of the middle rectal valve and of the peritoneal reflection (Kappa = 0.66). In addition, the peritoneal reflection was significantly lower in overweight patients (p = 0.013 for women and p < 0.005 for men) and in women with > 2 vaginal deliveries (p = 0.009), but there was no significant difference in the length of the peritoneal reflection between genders (p = 0.32). Conclusion There was substantial agreement between the lengths of the peritoneal reflection and of the middle rectal valve, and the peritoneal reflection was significantly lower in overweight patients and in women with more than two vaginal deliveries.

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“…Some studies compared conventional radiology and MRI defecography in order to determine the more suitable modality for pelvic floor hernias and other disorders, and it was determined that MRI defecography had a lower sensitivity in, for example, the detection of peritoneal sac herniations [ 250 ]. However, it was suggested that less invasive MRI defecography might be a strong candidate in the evaluation of the anatomy of the pelvic floor [ 256 ]. The best initial test for the diagnosis of constipation or obstructed defecation is transit time studies, followed by defecography.…”

Section: Imaging Of Gastrointestinal Diseasesmentioning

confidence: 99%

Imaging of Gastrointestinal Tract Ailments

Sun

Liu

et al. 2023

J. Imaging

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Gastrointestinal (GI) disorders comprise a diverse range of conditions that can significantly reduce the quality of life and can even be life-threatening in serious cases. The development of accurate and rapid detection approaches is of essential importance for early diagnosis and timely management of GI diseases. This review mainly focuses on the imaging of several representative gastrointestinal ailments, such as inflammatory bowel disease, tumors, appendicitis, Meckel’s diverticulum, and others. Various imaging modalities commonly used for the gastrointestinal tract, including magnetic resonance imaging (MRI), positron emission tomography (PET) and single photon emission computed tomography (SPECT), and photoacoustic tomography (PAT) and multimodal imaging with mode overlap are summarized. These achievements in single and multimodal imaging provide useful guidance for improved diagnosis, staging, and treatment of the corresponding gastrointestinal diseases. The review evaluates the strengths and weaknesses of different imaging techniques and summarizes the development of imaging techniques used for diagnosing gastrointestinal ailments.

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Role of conventional radiology and MRi defecography of pelvic floor hernias

Cited by 22 publications

References 36 publications

MR Imaging in Diagnosis of Pelvic Floor Descent: Supine versus Sitting Position

MR Imaging in Diagnosis of Pelvic Floor Descent: Supine versus Sitting Position

Is There a Precise Correlation between the Lengths of the Peritoneal Reflection and the Middle Rectal Valve?

Imaging of Gastrointestinal Tract Ailments

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