Singh Jai P, Assaie-Ardakany Shayan, Aleissa Maryam A, Al-Shaer Kareem, Chitragari Gautham, Drelichman Ernesto R, Mittal Vijay K, Bhullar Jasneet S
Department of Surgery, Henry Ford Providence Hospital, Michigan State University College of Human Medicine, Southfield, MI 48075, United States.
Department of Biological Science, Wayne State University, Detroit, MI 48202, United States.
World J Radiol. 2025 Jul 28;17(7):107459. doi: 10.4329/wjr.v17.i7.107459.
Obstructed defecation syndrome (ODS) is a complex defecatory disorder associated with pelvic floor dysfunction. It affects approximately 50% of women over the age of 50 and significantly impacts their quality of life. The causes of ODS include structural abnormalities such as rectocele, enterocele, intussusception, and pelvic floor descent, as well as functional disorders like anismus. Accurate diagnosis is crucial for effective management due to the high risk of treatment failure associated with inaccurate findings. Various imaging modalities are used to assess pelvic floor disorders, including fluoroscopic defecography (FD), magnetic resonance defecography (MRD), pelvic floor ultrasound (PFUS), and echodefecography (EDF). FD is the most commonly performed test worldwide, offering high accuracy in diagnosing pelvic floor disorders. It provides dynamic visualization of defecation mechanics but involves radiation exposure. MRD offers excellent soft tissue detail and multiplanar imaging without radiation, making it particularly useful for multicompartment disorders; however, it is associated with high procedural costs and limited availability. Both PFUS and EDF are minimally invasive and avoid radiation exposure. PFUS shows promise as a valuable screening tool that could help minimize the need for advanced imaging if findings are normal. EDF is also promising but requires specialized training and remains less widely available. This review evaluates the accuracy, advantages, and limitations of various diagnostic modalities for pelvic floor disorders, aiming to guide optimal clinical decision-making.
排便障碍综合征（ODS）是一种与盆底功能障碍相关的复杂排便紊乱疾病。它影响着约50%的50岁以上女性，并对她们的生活质量产生重大影响。ODS的病因包括直肠膨出、肠膨出、肠套叠和盆底下降等结构异常，以及如排便时盆底肌肉反常收缩等功能障碍。由于诊断结果不准确会导致治疗失败的风险很高，因此准确诊断对于有效治疗至关重要。各种成像方式被用于评估盆底疾病，包括荧光透视排便造影（FD）、磁共振排便造影（MRD）、盆底超声（PFUS）和超声排便造影（EDF）。FD是全球最常用的检查方法，在诊断盆底疾病方面具有很高的准确性。它能动态显示排便机制，但涉及辐射暴露。MRD能提供出色的软组织细节和多平面成像且无辐射，对多腔室疾病特别有用；然而，它的检查成本高且可用性有限。PFUS和EDF都是微创的，且避免了辐射暴露。如果检查结果正常，PFUS有望成为一种有价值的筛查工具，有助于减少对高级成像的需求。EDF也很有前景，但需要专门培训且应用范围仍较窄。本综述评估了各种诊断方式在盆底疾病诊断中的准确性、优势和局限性，旨在指导最佳临床决策。
