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Prospective Comparison between two different magnetic resonance defecography techniques for evaluating pelvic floor disorders: air-balloon versus gel for rectal filling

  • Gastrointestinal
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An Erratum to this article was published on 11 July 2016

Abstract

Purpose

to prospectively compare two rectal filling techniques for dynamic MRI of pelvic floor disorders (PFD).

Methods and materials

Twenty-six patients with PFD underwent the two techniques during the same procedure, one based on rectal placement of a balloon-catheter filled with saline and air insufflation (air-balloon technique or AB); another based on rectal filling with 180 cc of gel (gel-filling technique or GF). The examinations were compared for assessment and staging of PFD, including rectal-descent, rectocele, cystocele, colpocele, enterocele, rectal invagination. Surgery and clinical examinations were the gold standard.

Results

AB showed sensitivity of 96 % for rectal descent, 100 % for both rectocele and colpocele, 86 % for rectal invagination and 100 % for enterocele; understaged 11 % of rectal descents and 19 % of rectoceles. GF showed sensitivity of 100 % for rectal descent, 91 % for rectocele, 83 % for colpocele, 100 % for rectal invagination and 73 % for enterocele; understaged 3.8 % of rectal descent and 11.5 % of rectoceles. Both techniques showed 100 % of specificity. Agreement between air-balloon and gel filling was 84 % for rectal descent, 69 % for rectocele, 88 % for rectal invagination, 84 % for enterocele, 88 % for cystocele and 92 % for colpocele.

Conclusion

Both techniques allowed a satisfactory evaluation of PFD. The gel filling was superior for rectal invagination, the air-balloon for rectocele and anterior/middle compartment disorders.

Key Points

• A standardized MRI technique for assessing pelvic floor disorders is not yet established.

• This study compares two MRI techniques based on different rectal filling: air-balloon versus gel.

• Both MRI techniques proved to be valuable in assessing PFD, with good agreement.

• Air-balloon technique is more hygienic and better tolerated than the gel-filling technique.

• Gel was superior for rectal invagination, air-balloon for rectocele and uro-genital prolapses.

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Acknowledgments

A particular thank goes to Dr Luca Acquafredda for the statistical analysis, to Beatrice Bozzao and Charles T.A.Semelka for the English editing. The scientific guarantor of this publication is Francesca Maccioni, M.D., Phd. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective study.

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Authors and Affiliations

  1. Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy

    Maccioni Francesca, Al Ansari Najwa, Buonocore Valeria, Mazzamurro Fabrizio & Catalano Carlo

  2. Department of Surgical Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome, VialeRegina Elena 324, Rome, Italy

    Indinnimeo Marileda & Mongardini Massimo

Authors
  1. Maccioni Francesca
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  2. Al Ansari Najwa
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  3. Buonocore Valeria
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  4. Mazzamurro Fabrizio
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  6. Mongardini Massimo
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Correspondence to Maccioni Francesca.

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Francesca, M., Najwa, A.A., Valeria, B. et al. Prospective Comparison between two different magnetic resonance defecography techniques for evaluating pelvic floor disorders: air-balloon versus gel for rectal filling. Eur Radiol 26, 1783–1791 (2016). https://doi.org/10.1007/s00330-015-4016-5

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  • DOI: https://doi.org/10.1007/s00330-015-4016-5

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