Women's imaging center, hôpital de Valenciennes, avenue Désandrouin, 59300 Valenciennes, France.
Department of urology, hôpital Saint-Philibert, GHICL, 115, rue du Grand-But, BP 249, 59462 Lomme cedex, France.
Diagn Interv Imaging. 2017 Apr;98(4):327-332. doi: 10.1016/j.diii.2016.03.018. Epub 2017 Jan 11.
The goal of this study was to compare conventional X-ray defecography and dynamic magnetic resonance (MR) defecography in the diagnosis of pelvic floor prolapse of the posterior compartment.
Fifty women with a mean age of 65.5 years (range: 53-72 years) who underwent X-ray defecography and MR defecography for clinical suspicion of posterior compartment dysfunction, were included in this retrospective study. X-ray defecography and dynamic MR defecography were reviewed separately for the presence of pelvic organ prolapse. The results of the combination of X-ray defecography and MR defecography were used as the standard of reference. Differences in sensitivities between X-ray defecography and MR defecography were compared using the McNemar test.
With the gold standard, we evidenced a total of 22 cases of peritoneocele (17 elytroceles, 3 hedroceles and 2 elytroceles+hedroceles), including 15 cases of enterocele, 28 patients with rectocele including 16 that retained contrast, 37 cases of rectal prolapse, and 11 cases of anismus. The sensitivities of X-ray defecography were 90.9% for the diagnosis of peritoneocele, 71.4% for rectocele, 81.1% for rectal prolapse and 63.6% for anismus. The sensitivities of MR defecography for the same diagnoses were 86.4%, 78.6%, 62.2% and 63.6%, respectively. For all these pathologies, no significant differences between X-ray defecography and MR defecography were found.
Dynamic MR defecography is equivalent to X-ray defecography for the diagnosis of abnormalities of the posterior compartment of the pelvic floor.
本研究旨在比较常规 X 射线排粪造影和动态磁共振（MR）排粪造影在诊断骨盆底后腔脱垂中的作用。
本回顾性研究纳入了 50 名平均年龄为 65.5 岁（范围：53-72 岁）的女性，因怀疑后腔功能障碍而行 X 射线排粪造影和动态 MR 排粪造影。单独评估 X 射线排粪造影和动态 MR 排粪造影是否存在盆腔器官脱垂。将 X 射线排粪造影和 MR 排粪造影相结合的结果作为参考标准。使用 McNemar 检验比较 X 射线排粪造影和 MR 排粪造影的敏感性差异。
以金标准为依据，我们共发现 22 例腹膜膨出（17 例膈疝，3 例膈疝，2 例膈疝+膈疝），其中 15 例肠膨出，28 例直肠膨出，包括 16 例保留造影剂，37 例直肠前突和 11 例肛门失弛缓症。X 射线排粪造影对腹膜膨出、直肠膨出、直肠前突和肛门失弛缓症的诊断敏感度分别为 90.9%、71.4%、81.1%和 63.6%。MR 排粪造影对这些疾病的诊断敏感度分别为 86.4%、78.6%、62.2%和 63.6%。对于所有这些病变，X 射线排粪造影和 MR 排粪造影之间没有显著差异。
动态 MR 排粪造影与 X 射线排粪造影对诊断骨盆底后腔异常具有同等作用。
