Haliloglu Nuray, Erden Ayse
Ankara University Faculty of Medicine, Ankara, Turkey.
Pol J Radiol. 2022 Mar 20;87:e181-e185. doi: 10.5114/pjr.2022.114866. eCollection 2022.
Dyssynergic defecation (DD) is defined as paradoxical contraction or inadequate relaxation of the pelvic floor muscles during defecation, which causes functional constipation. Along with the anal manometry and balloon expulsion tests, magnetic resonance (MR) defecography is widely used to diagnose or rule out pelvic dyssynergia. Besides the functional abnormality, structural pathologies like rectocele, rectal intussusception, or rectal prolapse accompanying DD can also be well demonstrated by MR defecography. This examination can be an uncomfortable experience for the patient, so the imaging method and the importance of patient cooperation must be explained in detail. The defecatory phase of the examination is indispensable for evaluation, and inadequate effort should be ruled out before diagnosing DD. MR defecography provides important data for the diagnosis of DD, but optimal imaging criteria should be applied. Further tests can be suggested if patient co-operation is not sufficient or MR defecography findings are irrelevant.
排便协同失调(DD)被定义为排便时盆底肌肉反常收缩或松弛不足,从而导致功能性便秘。除肛门测压法和气囊排出试验外,磁共振(MR)排粪造影术也被广泛用于诊断或排除盆腔协同失调。除了功能异常外,MR排粪造影术还能很好地显示伴随DD出现的诸如直肠膨出、直肠套叠或直肠脱垂等结构病变。这项检查对患者来说可能是一次不舒服的体验,因此必须详细解释成像方法以及患者配合的重要性。检查的排便阶段对于评估不可或缺,在诊断DD之前应排除用力不足的情况。MR排粪造影术为DD的诊断提供了重要数据,但应采用最佳成像标准。如果患者配合不充分或MR排粪造影结果不相关,则可建议进一步检查。