Lienemann A, Anthuber C, Baron A, Reiser M
Department of Radiology, Klinikum Grosshadern, Ludwig Maximillians University Munich, Germany.
Dis Colon Rectum. 2000 Feb;43(2):205-12; discussion 212-3. doi: 10.1007/BF02236984.
Enteroceles are in part difficult to detect but a frequent finding in pelvic floor disorders. The aim of this study was to evaluate magnetic resonance colpocystorectography in the diagnosis of enteroceles.
In this prospective study 11 volunteers and 55 patients with pelvic floor descent were examined. In addition to magnetic resonance colpocystorectography, a dynamic cystoproctography was performed on 34 patients. Opacification of organs was used. An enterocele was assessed in relationship to the pubococcygeal reference line (magnetic resonance colpocystorectography) or the width of the rectovaginal space (dynamic cystoproctography). A clinical gynecologic examination served as reference.
The clinical examination diagnosed an enterocele in 43, magnetic resonance colpocystorectography in 49, and dynamic cystoproctography in 14 cases. Magnetic resonance colpocystorectography further subdivided the enteroceles according to their contents (mesenteric fat or fluid, 12; small bowel, 32, large bowel, 3; and rectosigmoidocele, 2). Magnetic resonance colpocystorectography proved statistically significantly superior to dynamic cystoproctography (15 cases) and the reference. Sensitivity and specificity of magnetic resonance colpocystorectography were 100 percent each. It was able to reveal clinically missed enteroceles as being peritoneoceles associated with a rectocele or a uterovaginal prolapse (10 cases).
Magnetic resonance colpocystorectography is a promising method for diagnosis of enteroceles, because hernial canal, sac, and contents are reliably identified.
肠膨出部分难以检测，但却是盆底功能障碍中常见的发现。本研究的目的是评估磁共振阴道膀胱直肠造影术在肠膨出诊断中的作用。
在这项前瞻性研究中，对11名志愿者和55名盆底下降患者进行了检查。除磁共振阴道膀胱直肠造影术外，还对34名患者进行了动态膀胱直肠造影术。采用器官造影法。根据耻骨尾骨参考线（磁共振阴道膀胱直肠造影术）或直肠阴道间隙宽度（动态膀胱直肠造影术）评估肠膨出。临床妇科检查作为对照。
临床检查诊断出43例肠膨出，磁共振阴道膀胱直肠造影术诊断出49例，动态膀胱直肠造影术诊断出14例。磁共振阴道膀胱直肠造影术根据其内容物进一步细分肠膨出（肠系膜脂肪或液体，12例；小肠，32例；大肠，3例；直肠乙状结肠膨出，2例）。磁共振阴道膀胱直肠造影术在统计学上明显优于动态膀胱直肠造影术（15例）和对照检查。磁共振阴道膀胱直肠造影术的敏感性和特异性均为100%。它能够发现临床上漏诊的与直肠膨出或子宫阴道脱垂相关的腹膜膨出的肠膨出（10例）。
磁共振阴道膀胱直肠造影术是诊断肠膨出的一种有前景的方法，因为它能可靠地识别疝管、疝囊及其内容物。
