Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
Division of Gastroenterology, Department of Surgery, Oulu University Hospital, Oulu, Finland.
Colorectal Dis. 2022 Jun;24(6):747-753. doi: 10.1111/codi.16081. Epub 2022 Feb 17.
The aim of this work was to study the technical success and diagnostic capability of magnetic resonance defaecography (MRD) compared with video defaecography (VD).
Sixty four women with defaecation disorders underwent both MRD and x-ray VD over 1 year. The assessment by two radiologists in consensus was retrospective and blinded. The technical success of straining and evacuation was evaluated subjectively. The presence of enterocele, intussusception, rectocele and dyssynergic defaecation was analysed according to established criteria, with VD as the standard of reference.
It was found that 62/64 (96.9%) VD studies were technically fully diagnostic compared with 29/64 (45.3%) for MRD. The number of partially diagnostic studies was 1/64 (1.6%) for VD versus 21/64 (32.8%) for MRD, with 1/64 (1.6%) (VD) and 14/64 (21.9%) (MRD) being nondiagnostic. Thirty enteroceles were observed by VD compared with seven in MRD with moderate agreement (κ = 0.41). Altogether 53 intussusceptions were observed by VD compared with 27 by MRD with poor agreement (κ = -0.10 and κ = 0.02 in recto-rectal and recto-anal intussusception, respectively). Moderate agreement (κ = 0.47) was observed in diagnosing rectocele, with 47 cases by VD and 29 by MRD. Dyssynergic defaecation was observed in three patients by VD and in 11 patients by MRD, with slight agreement (κ = 0.14).
The technical success and diagnostic capabilities of VD are better than those of MRD. VD remains the method of choice in the imaging of defaecation disorders.
本研究旨在比较磁共振排粪造影（MRD）与 X 射线排粪造影（VD）的技术成功率和诊断能力。
64 例排便障碍患者在 1 年内分别接受了 MRD 和 X 射线 VD 检查。两位放射科医生进行了回顾性盲法评估。通过主观评估来评估排便时的技术成功率。根据既定标准分析会阴下降、套叠、直肠前突和协同性排便障碍的存在情况，以 VD 为参考标准。
发现 64 例 VD 研究中，有 62 例（96.9%）为完全诊断性研究，而 64 例 MRD 研究中仅有 29 例（45.3%）为完全诊断性研究。部分诊断性研究的数量在 VD 中为 1 例（1.6%），在 MRD 中为 21 例（32.8%），而 VD 中有 1 例（1.6%）和 MRD 中有 14 例（21.9%）为非诊断性研究。VD 观察到 30 例会阴下降，MRD 观察到 7 例，一致性中等（κ=0.41）。VD 观察到 53 例套叠，MRD 观察到 27 例，一致性差（直肠-直肠套叠和直肠-肛门套叠的κ值分别为-0.10 和 0.02）。VD 观察到 47 例直肠前突，MRD 观察到 29 例，一致性中等（κ=0.47）。VD 观察到 3 例协同性排便障碍，MRD 观察到 11 例，一致性弱（κ=0.14）。
VD 的技术成功率和诊断能力优于 MRD。VD 仍然是排便障碍成像的首选方法。
