Schoenenberger A W, Debatin J F, Guldenschuh I, Hany T F, Steiner P, Krestin G P
Institute of Diagnostic Radiology, University Hospital Zurich, Switzerland.
Radiology. 1998 Mar;206(3):641-6. doi: 10.1148/radiology.206.3.9494480.
To evaluate dynamic magnetic resonance (MR) defecography performed with a superconducting, open-configuration system in diagnosis of defecation disorders.
Five healthy volunteers and 15 patients with defecation disorders were studied with MR defecography performed with a superconducting, open-configuration system; the patients also underwent fluoroscopic defecography. Before MR imaging, the rectum was filled with 300 mL of mashed potatoes mixed with 1.5 mL of gadopentetate dimeglumine. T1-weighted gradient-echo images were acquired every 2 seconds in the midsagittal plane with the patient at rest, at maximal contraction of the anal sphincter, during straining, and during defecation.
MR defecography permitted analysis of the anorectal angle, anal canal, puborectal muscle, and descent of the pelvic floor. Owing to the high signal intensity of the intraluminal contrast material, the rectal walls were well demonstrated on the MR images, permitting visualization of intussusception and rectocele. Concomitant demonstration of structures surrounding the anorectal canal was helpful in assessment of spastic pelvic floor syndrome and descending perineum syndrome. MR defecography was superior to fluoroscopic defecography and allowed detection of all clinically relevant pathologic conditions except for one.
Dynamic MR defecography is an attractive alternative for evaluation of defecation disorders.
评估使用超导开放式系统进行的动态磁共振排粪造影在排便障碍诊断中的应用。
对5名健康志愿者和15名排便障碍患者进行了使用超导开放式系统的磁共振排粪造影研究；这些患者还接受了荧光透视排粪造影。在磁共振成像前，直肠内注入300 mL与1.5 mL钆喷酸葡胺混合的土豆泥。在矢状面中，让患者处于静息状态、肛门括约肌最大收缩时、用力排便时和排便过程中，每2秒采集一次T1加权梯度回波图像。
磁共振排粪造影可分析肛管直肠角、肛管、耻骨直肠肌和盆底下降情况。由于腔内对比剂的高信号强度，直肠壁在磁共振图像上显示良好，可观察到套叠和直肠膨出。同时显示肛管周围结构有助于评估痉挛性盆底综合征和会阴下降综合征。磁共振排粪造影优于荧光透视排粪造影，除1例情况外，能检测出所有临床相关的病理状况。
动态磁共振排粪造影是评估排便障碍的一种有吸引力的替代方法。
