Research Article
Volume 9 Issue 5 - 2022
Advances in MR Defecography: Analysis of Rectal Clearance
Vittorio Piloni1*, Marco Fogante2 and Tiziana Manisco1
1Consultant Radiologist, Diagnostic Imaging Center “Diagnostica Marche” Osimo Stazione, Ancona, Italy
2Department of Radiology, University Hospital, Ospedali Riuniti, Ancona, Italy
*Corresponding Author: Vittorio Piloni, Consultant Radiologist, Diagnostic Imaging Center “Diagnostica Marche” Osimo Stazione, Ancona, Italy.
Received: May 02, 2022; Published: May 25, 2022




Abstract

Aim: To describe a technique, to be embedded into routine image processing, by which the quantitation of rectal area decrease is displayed synchronous with its graphic representation together with the image of rectal contrast emptying in a cinematic mode.

Method: The imaging series of two-hundred and twenty nine consecutive patients (191 females, 38 males, mean age and SD, 56.57 ± 14.4 yrs and 50.7 ± 16.6 yrs, respectively) with impaired defecation, fecal incontinence and prolapse syndromes who underwent MR defecography between April 2017 and July 2021, were retrospectively reviewed. The “clearance” of acoustic gel during rectal emptying is calculated planimetrically on MR sagittal images as the value of rectal area before evacuation minus the value after evacuation divided by value before evacuation × 100. In addition, the flow rate, is calculated as the change of rectal area by time (cm2/sec). Subsequently, values are displayed as a graph on the screen as the change of rectal area synchronous with the contrast emptying. The shape of the curve, numerical data and MR images are compared with clinical findings and presenting symptoms for characterization of pathologies.

Results: Average clearance values differed significantly (p, < 0.001) among the three groups i.e. 31.18 cm2 ± 23.34 in the obstructed group, 45.12 cm2 ± 22.53 in the prolapse group, and 58.27 cm2 ± 16.50 in the incontinent group. The same occurred for the flow rate i.e. 0.19 cm2/sec ± 0.15, 0.30 cm2/sec ± 0.16, and 0.83 cm2/sec ± 0.25, respectively. Rectocele accounted for the most frequent abnormality (68%) seen in the obstructed group, and the combination of rectal clearance, flow rate with graphic display and imaging feature allowed recognition of two different sub types.

Conclusion: The application of the above method indicates that a better discrimination of categories and subcategories of pathologies can be obtained in patients with functional disorders of defecation, with potential influence on therapy planning.

Keywords: Magnetic Resonance Imaging; Defecography; Pelvic Floor Dysfunctions; Obstructed Defecation Syndrome; Pelvic Organ Prolapse; Chronic Constipation

References

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Citation: Vittorio Piloni., et al. “Advances in MR Defecography: Analysis of Rectal Clearance”. EC Gastroenterology and Digestive System 9.5 (2022): 33-40

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