Müller-Schimpfle M, Franz H, Lobinger B, Claussen C D
Radiologische Klinik, Abteilung für Radiologische Diagnostik, Universität Tübingen.
Rofo. 1995 Jun;162(6):478-81. doi: 10.1055/s-2007-1015921.
To assess the visualisation of the anal sphincter by means of an intravaginal surface coil.
MR imaging was performed using a 1.0 T unit. In 10 females (6 nullipara, one primipara without and three primipara with postpartum faecal incontinence) a surface coil, originally designed for endorectal use, was placed into the vagina. Transverse oblique T1-weighted spin echo and double echo turbo spin echo sequences with T2- and proton density-weighting were acquired parallel to the puborectal, rectococcygeal and anorectal planes. Three readers analysed the images in consensus.
The anatomic structures of the external and internal sphincter as well as the mucosa were differentiated in all cases with a good contrast. The best results were yielded by the proton density weighting. In one case of faecal incontinence a sphincter defect after repair of a complete rupture of the anal sphincter was shown. In another case irregularities in the structure of the external sphincter and perineum were visualised.
Intravaginal surface coil imaging seems a well-tolerated novel method for the evaluation of the anal sphincter tissues in truly anatomical states. Due to its capability to depict subtle tissue structures as well as pathologic irregularities, it might become a potential tool in the diagnosis and operation planning of postpartal faecal incontinence.
通过阴道内表面线圈评估肛门括约肌的可视化情况。
使用1.0T设备进行磁共振成像。对10名女性（6名未产妇、1名初产妇无产后大便失禁、3名初产妇有产后大便失禁），将原本设计用于直肠内的表面线圈置于阴道内。获取与耻骨直肠肌、直肠尾骨肌和肛管直肠平面平行的横向斜位T1加权自旋回波序列以及具有T2加权和质子密度加权的双回波快速自旋回波序列。三位阅片者共同分析图像。
在所有病例中均能清晰区分外括约肌、内括约肌以及黏膜的解剖结构，对比度良好。质子密度加权获得的结果最佳。在1例大便失禁病例中，显示了肛门括约肌完全断裂修复后出现的括约肌缺损。在另一例中，观察到外括约肌和会阴结构的不规则情况。
阴道内表面线圈成像似乎是一种耐受性良好的新方法，可用于在真实解剖状态下评估肛门括约肌组织。由于其能够描绘细微的组织结构以及病理不规则情况，它可能成为产后大便失禁诊断和手术规划的潜在工具。
