Schawkat Khoschy, Pfister Bettina, Parker Helen, Heinrich Henriette, Barth Borna K, Weishaupt Dominik, Fox Mark, Reiner Caecilia S
1 Institute of Diagnostic and Interventional Radiology, University Hospital Zurich , Zurich , Switzerland.
2 University Zurich , Zurich , Switzerland.
Br J Radiol. 2018 Dec;91(1092):20180393. doi: 10.1259/bjr.20180393. Epub 2018 Sep 18.
: To investigate the performance of MR-defecography (MRD) in lateral body position as an alternative to supine position.
: 22 consecutive patients (16 females; mean age 51 ± 19.4) with obstructed defecation and 20 healthy volunteers (11 females; mean age 33.4 ± 11.5) underwent MRD in a closed-configuration 3T-MRI in supine and lateral position. MRD included T weighted images at rest and during defecation after filling the rectum with 250 ml water-based gel. Measurements were performed in reference to the pubococcygeal line and grade of evacuation was assessed. Image quality (IQ) was rated on a 5-point-scale (5 = excellent).
: In patients grades of middle and posterior compartment descent were similar in both body positions (p > 0.05). Grades of anterior compartment descent were significantly higher in lateral position (21/22 vs 17/22 patients with normal or small descent, p < 0.034). In volunteers grades of descent were similar for all compartments in supine and lateral position (p > 0.05). When attempting to defecate in supine position 6/22 (27%) patients showed no evacuation, while in lateral position only 3/22 (14%) were not able to evacuate. IQ in patients was equal at rest (4.4 ± 0.5 and 4.7 ± 0.6, p > 0.05) and slightly better in supine compared to the lateral position during defecation (4.5 ± 0.4 vs 3.9 ± 0.9, p < 0.017). IQ in volunteers was equal in supine and lateral position (p > 0.05).
: In lateral position, more patients were able to evacuate with similar grades of pelvic floor descent compared to supine position. MRD in lateral position may be a valuable alternative for patients unable to defecate in supine position.
: In lateral position, more patients were able to evacuate during MRD. MRD in lateral position may be an alternative for patients unable to defecate in supine position.
研究侧卧位磁共振排粪造影（MRD）作为仰卧位替代方法的性能。
22例连续的排便障碍患者（16例女性；平均年龄51±19.4岁）和20名健康志愿者（11例女性；平均年龄33.4±11.5岁）在封闭配置的3T磁共振成像仪上分别进行仰卧位和侧卧位的MRD检查。MRD包括在直肠注入250ml水基凝胶后静息期和排便期的T加权图像。测量参考耻骨尾骨线进行，并评估排空等级。图像质量（IQ）采用5分制评分（5分=优秀）。
在患者中，两种体位下中后盆腔下降等级相似（p>0.05）。侧卧位前盆腔下降等级显著更高（21/22例与17/22例正常或轻度下降患者，p<0.034）。在志愿者中，仰卧位和侧卧位所有盆腔区域的下降等级相似（p>0.05）。在仰卧位尝试排便时，6/22（27%）例患者未出现排空，而在侧卧位时只有3/22（14%）例患者无法排空。患者静息期的IQ相等（4.4±0.5和4.7±0.6，p>0.05），排便期仰卧位的IQ略优于侧卧位（4.5±0.4 vs 3.9±0.9，p<0.017）。志愿者仰卧位和侧卧位的IQ相等（p>0.05）。
与仰卧位相比，侧卧位时有更多患者能够在盆底下降等级相似的情况下完成排空。侧卧位MRD可能是无法在仰卧位排便的患者的一种有价值的替代方法。
在侧卧位时，更多患者在MRD检查期间能够完成排空。侧卧位MRD可能是无法在仰卧位排便的患者的一种替代方法。
