Dynamic MR Imaging in the Evaluation of Outlet Obstruction

  • N. Bolog
  • D. Weishaupt
  • B. Marincek
Chapter

Conclusion

Dynamic pelvic MRI using either closed-configuration or open-configuration MR systems is a rapidly evolving technique that is considered an alternative to conventional evacuation proctography. In patients with outlet obstruction, the technique may reveal various findings associated with outlet obstruction.

Keywords

Pelvic Floor Outlet Obstruction Rectal Prolapse Incomplete Evacuation Magnetic Resonance System 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Sonnenberg A, Koch TR (1989) Epidemiology of constipation in the United States. Dis Colon Rectum 32:1–8PubMedGoogle Scholar
  2. 2.
    Drossman DA, Li Z, Andruzzi E et al (1993) U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci 38:1569–1580PubMedCrossRefGoogle Scholar
  3. 3.
    Everhart JE, Go VL, Johannes RS et al (1989) A longitudinal survey of self-reported bowel habits in the United States. Dig Dis Sci 34:1153–1162PubMedCrossRefGoogle Scholar
  4. 4.
    Jones R, Lydeard S (1992) Irritable bowel syndrome in the general population. BMJ 304:87–90PubMedCrossRefGoogle Scholar
  5. 5.
    Talley NJ, Zinsmeister AR, Van Dyke C et al (1991) Epidemiology of colonic symptoms and the irritable bowel syndrome. Gastroenterology 101:927–934PubMedGoogle Scholar
  6. 6.
    Bruch HP, Fischer F, Schiedeck TH et al (2004) [Obstructed defecation]. Chirurg 75:861–870PubMedCrossRefGoogle Scholar
  7. 7.
    D’Hoore A, Penninckx F (2003) Obstructed defecation. Colorectal Dis 5:280–287PubMedCrossRefGoogle Scholar
  8. 8.
    Zonca G, De Thomatis A, Marchesini R et al (1997) The absorbed dose to the gonads in adult patients undergoing defecographic study by digital or traditional radiographic imaging. Radiol Med 94:520–523PubMedGoogle Scholar
  9. 9.
    Goei R, Kemerink G (1990) Radiation dose in defecography. Radiology 176:137–139PubMedGoogle Scholar
  10. 10.
    Bertschinger KM, Hetzer FH, Roos JE et al (2002) Dynamic MR imaging of the pelvic floor performed with patient sitting in an open-magnet unit versus with patient supine in a closed-magnet unit. Radiology 223:501–508PubMedGoogle Scholar
  11. 11.
    Vanbeckevoort D, Van Hoe L, Oyen R et al (1999) Pelvic floor descent in females: comparative study of colpocystodefecography and dynamic fast MR imaging. J Magn Reson Imaging 9:373–377PubMedCrossRefGoogle Scholar
  12. 12.
    Mibu R, Hotokezaka M, Kai T et al (2001) A simplified defaecographic procedure for the assessment of faecal incontinence or obstructed defaecation. Colorectal Dis 3:328–333PubMedCrossRefGoogle Scholar
  13. 13.
    Lienemann A, Anthuber C, Baron A et al (1997) Dynamic MR colpocystorectography assessing pelvicfloor descent. Eur Radiol 7:1309–1317PubMedCrossRefGoogle Scholar
  14. 14.
    Kelvin FM, Maglinte DD, Hale DS, Benson JT (2000) Female pelvic organ prolapse: a comparison of triphasic dynamic MR imaging and triphasic fluoroscopic cystocolpoproctography. AJR Am J Roentgenol 174:81–88PubMedGoogle Scholar
  15. 15.
    Fletcher JG, Busse RF, Riederer SJ et al (2003) Magnetic resonance imaging of anatomic and dynamic defects of the pelvic floor in defecatory disorders. Am J Gastroenterol 98:399–411PubMedCrossRefGoogle Scholar
  16. 16.
    Dvorkin LS, Hetzer F, Scott SM et al (2004) Open-magnet MR defaecography compared with evacuation proctography in the diagnosis and management of patients with rectal intussusception. Colorectal Dis 6:45–53PubMedCrossRefGoogle Scholar
  17. 17.
    Roos JE, Weishaupt D, Wildermuth S et al (2002) Experience of 4 years with open MR defecography: pictorial review of anorectal anatomy and disease. Radiographics 22:817–832PubMedGoogle Scholar
  18. 18.
    Lamb GM, de Jode MG, Gould SW et al (2000) Upright dynamic MR defaecating proctography in an open configuration MR system. Br J Radiol 73:152–155PubMedGoogle Scholar
  19. 19.
    Maglinte DD, Kelvin FM, Fitzgerald K et al (1999) Association of compartment defects in pelvic floor dysfunction. AJR Am J Roentgenol 172:439–444PubMedGoogle Scholar
  20. 20.
    Healy JC, Halligan S, Reznek RH et al (1997) Dynamic MR imaging compared with evacuation proctography when evaluating anorectal configuration and pelvic floor movement. AJR Am J Roentgenol 169:775–779PubMedGoogle Scholar
  21. 21.
    Stoker J, Halligan S, Bartram CI (2001) Pelvic floor imaging. Radiology 218:621–641PubMedGoogle Scholar
  22. 22.
    Comiter CV, Vasavada SP, Barbaric ZL et al (1999) Grading pelvic prolapse and pelvic floor relaxation using dynamic magnetic resonance imaging. Urology 54:454–457PubMedCrossRefGoogle Scholar
  23. 23.
    Gufler H, Laubenberger J, DeGregorio G et al (1999) Pelvic floor descent: dynamic MR imaging using a half-Fourier RARE sequence. J Magn Reson Imaging 9:378–383PubMedCrossRefGoogle Scholar
  24. 24.
    Pannu HK, Kaufman HS, Cundiff GW et al (2000) Dynamic MR imaging of pelvic organ prolapse: spectrum of abnormalities. Radiographics 20:1567–1582PubMedGoogle Scholar
  25. 25.
    Kelvin FM, Maglinte DD (2001) Extended proctography. Imaging 13:448–457Google Scholar
  26. 26.
    Maglinte DD, Kelvin FM, Hale DS et al (1997) Dynamic cystoproctography: a unifying diagnostic approach to pelvic floor and anorectal dysfunction. AJR Am J Roentgenol 169:759–767PubMedGoogle Scholar
  27. 27.
    Shorvon PJ, McHugh S, Diamant NE et al (1989) Defecography in normal volunteers: results and implications. Gut 30:1737–1749PubMedGoogle Scholar
  28. 28.
    Siproudhis L, Dautreme S, Ropert A et al (1993) Dyschezia and rectocele–a marriage of convenience? Physiologic evaluation of the rectocele in a group of 52 women complaining of difficulty in evacuation. Dis Colon Rectum 36:1030–1036PubMedCrossRefGoogle Scholar
  29. 29.
    Pfeifer J, Oliveira L, Park UC et al (1997) Are interpretations of video defecographies reliable and reproducible? Int J Colorectal Dis 12:67–72PubMedCrossRefGoogle Scholar
  30. 30.
    Mahieu P, Pringot J, Bodart P (1984) Defecography: II Contribution to the diagnosis of defecation disorders Gastrointest Radiol 9:253–261PubMedCrossRefGoogle Scholar
  31. 31.
    Sarles JC, Arnaud A, Selezneff I, Olivier S (1989) Endorectal repair of rectocele. Int J Colorectal Dis 4:167–171PubMedCrossRefGoogle Scholar
  32. 32.
    Johansson C, Nilsson BY, Mellgren A et al (1992) Paradoxical sphincter reaction and associated colorectal disorders. Int J Colorectal Dis 7:89–94PubMedCrossRefGoogle Scholar
  33. 33.
    Mellgren A, Anzen B, Nilsson BY et al (1995) Results of rectocele repair. A prospective study. Dis Colon Rectum 38:7–13PubMedCrossRefGoogle Scholar
  34. 34.
    Marti MC, Roche B, Deleaval J (1999) Rectoceles: value of videodefaecography in selection of treatment policy. Colorectal Dis 1:324–329CrossRefGoogle Scholar
  35. 35.
    Healy JC, Halligan S, Reznek RH et al (1997) Patterns of prolapse in women with symptoms of pelvic floor weakness: assessment with MR imaging. Radiology 203:77–81PubMedGoogle Scholar
  36. 36.
    Lowry AC, Simmang CL, Boulos P et al (2001) Consensus statement of definitions for anorectal physiology and rectal cancer. Colorectal Dis 3:272–275PubMedCrossRefGoogle Scholar
  37. 37.
    Yang A, Mostwin JL, Rosenshein NB, Zerhouni EA (1991) Pelvic floor descent in women: dynamic evaluation with fast MR imaging and cinematic display. Radiology 179:25–33PubMedGoogle Scholar
  38. 38.
    Hock D, Lombard R, Jehaes C et al (1993) Colpocystodefecography. Dis Colon Rectum 36:1015–1021PubMedCrossRefGoogle Scholar
  39. 39.
    Kelvin FM, Maglinte DD, Hornback JA, Benson JT (1992) Pelvic prolapse: assessment with evacuation proctography (defecography). Radiology 184:547–551PubMedGoogle Scholar
  40. 40.
    Hauck R (1993) Enterocele. In: Buchmann P, Brühlmann W (eds) Investigation of anorectal functional disorders. Springer, Berlin Heidelberg New York, pp 170–189Google Scholar
  41. 41.
    Karasick S, Karasick D, Karasick SR (1993) Functional disorders of the anus and rectum: findings on defecography. AJR Am J Roentgenol 160:777–782PubMedGoogle Scholar
  42. 42.
    Kelvin FM, Hale DS, Maglinte DD et al (1999) Female pelvic organ prolapse: diagnostic contribution of dynamic cystoproctography and comparison with physical examination. AJR Am J Roentgenol 173:31–37PubMedGoogle Scholar
  43. 43.
    Hilfiker PR, Debatin JF, Schwizer W et al (1998) MR defecography: depiction of anorectal anatomy and pathology. J Comput Assist Tomogr 22:749–755PubMedCrossRefGoogle Scholar
  44. 44.
    Stoker J, Bartram CI, Halligan S (2002) Imaging of the posterior pelvic floor. Eur Radiol 12:779–788PubMedCrossRefGoogle Scholar
  45. 45.
    Kelvin FM, Maglinte DD, Benson JT (1994) Evacuation proctography (defecography): an aid to the investigation of pelvic floor disorders. Obstet Gynecol 83:307–314PubMedGoogle Scholar
  46. 46.
    Fenner DE (1996) Diagnosis and assessment of sigmoidoceles. Am J Obstet Gynecol 175:1438–1442PubMedCrossRefGoogle Scholar
  47. 47.
    Jorge JM, Yang YK, Wexner SD (1994) Incidence and clinical significance of sigmoidoceles as determined by a new classification system. Dis Colon Rectum 37:1112–1117PubMedCrossRefGoogle Scholar
  48. 48.
    Keigley M, et al (1992) Rectal prolapse. In: Henry MM, Swash M (eds) Coloproctology and the pelvic floor, 2nd edn. Butterworth-Heinemann, Oxford, pp. 316–350Google Scholar
  49. 49.
    Kodner IJ, Fry RD, Fleshman JW (1992) Rectal prolapse and other pelvic floor abnormalities. Surg Annu 24:157–190PubMedGoogle Scholar
  50. 50.
    Goei R (1990) Anorectal function in patients with defecation disorders and asymptomatic subjects: evaluation with defecography. Radiology 174:121–123PubMedGoogle Scholar
  51. 51.
    Pomerri F, Zuliani M, Mazza C et al (2001) Defecographic measurements of rectal intussusception and prolapse in patients and in asymptomatic subjects. AJR Am J Roentgenol 176:641–645PubMedGoogle Scholar
  52. 52.
    Tsiaoussis J, Chrysos E, Glynos M et al (1998) Pathophysiology and treatment of anterior rectal mucosal prolapse syndrome. Br J Surg 85: 1699–1702PubMedCrossRefGoogle Scholar
  53. 53.
    Parks AG, Porter NH, Hardcastle J (1966) The syndrome of the descending perineum. Proc R Soc Med 59:477–482PubMedGoogle Scholar
  54. 54.
    Henry MM, Parks AG, Swash M (1982) The pelvic floor musculature in the descending perineum syndrome. Br J Surg 69:470–472PubMedGoogle Scholar
  55. 55.
    Snooks SJ, Swash M, Henry MM, Setchell M (1986) Risk factors in childbirth causing damage to the pelvic floor innervation. Int J Colorectal Dis 1:20–24PubMedCrossRefGoogle Scholar
  56. 56.
    Locke GR 3rd, Pemberton JH, Phillips SF (2000) AGA technical review on constipation. American Gastroenterological Association. Gastroenterology 119:1766–1778PubMedGoogle Scholar
  57. 57.
    Whitehead WE, Wald A, Diamant NE et al (1999) Functional disorders of the anus and rectum. Gut 45(Suppl 2):55–59Google Scholar
  58. 58.
    Marshall M, Halligan S (2001) Evacuation proctography. Imaging 13:440–447Google Scholar
  59. 59.
    Rao SS, Welcher KD, Pelsang RE (1997) Effects of biofeedback therapy on anorectal function in obstructive defecation. Dig Dis Sci 42:2197–2205PubMedCrossRefGoogle Scholar
  60. 60.
    Leroi AM, Berkelmans I, Denis P et al (1995) Anismus as a marker of sexual abuse. Consequences of abuse on anorectal motility Dig Dis Sci 40:1411–1416PubMedCrossRefGoogle Scholar
  61. 61.
    Wald A, Caruana BJ, Freimanis MG et al (1990) Contributions of evacuation proctography and anorectal manometry to evaluation of adults with constipation and defecatory difficulty. Dig Dis Sci 35:481–487PubMedCrossRefGoogle Scholar
  62. 62.
    Jorge JM, Wexner SD, Ger GC et al (1993) Cinedefecography and electromyography in the diagnosis of nonrelaxing puborectalis syndrome. Dis Colon Rectum 36:668–676PubMedCrossRefGoogle Scholar
  63. 63.
    Jones PN, Lubowski DZ, Swash M, Henry MM (1987) Is paradoxical contraction of puborectalis muscle of functional importance? Dis Colon Rectum 30:667–670PubMedGoogle Scholar
  64. 64.
    Halligan S, Malouf A, Bartram CI et al (2001) Predictive value of impaired evacuation at proctography in diagnosing anismus. AJR Am J Roentgenol 177:633–636PubMedGoogle Scholar
  65. 65.
    Kuijpers HC, Bleijenberg G (1985) The spastic pelvic floor syndrome. A cause of constipation. Dis Colon Rectum 28:669–672PubMedGoogle Scholar
  66. 66.
    Halligan S, Bartram CI, Park HJ, Kamm MA (1995) Proctographic features of anismus. Radiology 197: 679–682PubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2006

Authors and Affiliations

  • N. Bolog
    • 1
  • D. Weishaupt
    • 1
  • B. Marincek
    • 1
  1. 1.Institute of Diagnostic RadiologyUniversity HospitalZürichSwitzerland

Personalised recommendations