Multi-Modality Medical Imaging, Faculty of Science and Technology, Technical Medical Centre, University of Twente, Building Technohal, Drienerlolaan 5, 7522, NB, Enschede, The Netherlands.
Department of Obstetrics and Gynecology, Ziekenhuisgroep Twente, Hengelo, The Netherlands.
Int Urogynecol J. 2023 Feb;34(2):507-515. doi: 10.1007/s00192-022-05181-x. Epub 2022 Apr 11.
Conventional defecography and MRI defecography can be requested as an additional test for diagnosing and differentiating the type of posterior compartment prolapse and/or obstructive defecation disorders. The objective of this study was to determine the added value of conventional defecography, conventional defecography and MRI defecography for clinical decision-making on treatment for patients with posterior compartment prolapse.
Four gynecologists were asked to fill in their treatment plan per patient for 32 cases for three different steps. Step 1 consisted of information on the anamnesis and physical examination (POP-Q). Step 2 consisted of Step 1, including conventional defecography (group A) or MRI defecography (group B). In Step 3, all gynecologists received the information on Step 1 including both conventional defecography and MRI defecography. Data analysis solely focused on the assessment of changes in the gynecological treatment plan of the posterior compartment.
After Step 2 a change in treatment plan occurred in 37% and 48% of the women in groups A and B, respectively. Accordingly, after Step 3 (including all imaging data), a change in treatment plan occurred in 19% and 52% of the women in groups A and B, respectively. A change within the surgery group (when a different type of surgery was selected) was seen for a total of 11 cases in group A and 20 in group B in all steps combined.
Both conventional defecography and MRI defecography had an large effect on the treatment plan for patients with posterior compartment prolapse. The dedicated added value of the imaging modality individually cannot be concluded yet.
常规排粪造影和 MRI 排粪造影可作为诊断和区分后盆腔脱垂和/或阻塞性排便障碍类型的附加检查。本研究的目的是确定常规排粪造影、常规排粪造影和 MRI 排粪造影对后盆腔脱垂患者治疗临床决策的附加价值。
要求 4 名妇科医生对 32 例患者的 3 个不同步骤分别填写他们的治疗计划。第 1 步包括病史和体格检查（POP-Q）的信息。第 2 步包括第 1 步，包括常规排粪造影（A 组）或 MRI 排粪造影（B 组）。在第 3 步中，所有妇科医生都收到了第 1 步的信息，包括常规排粪造影和 MRI 排粪造影。数据分析仅集中于评估后盆腔妇科治疗计划的变化。
第 2 步后，A 组和 B 组分别有 37%和 48%的女性改变了治疗计划。相应地，在第 3 步（包括所有影像学数据）后，A 组和 B 组分别有 19%和 52%的女性改变了治疗计划。在所有步骤中，A 组共有 11 例和 B 组共有 20 例手术组（当选择不同类型的手术时）发生了手术计划的改变。
常规排粪造影和 MRI 排粪造影均对后盆腔脱垂患者的治疗计划有较大影响。但目前还不能确定影像学检查方法各自的专门附加价值。
