Korean J Neurogastroenterol Motil.  2003 Dec;9(2):142-150.

Utility of Dynamic MR Defecography in Chronic Functional Constipation

• Chung EJ
• Myung SJ
• Kim AY
• Ha HK
• Song HK
• Chang HS
• Byeon JS
• Lee GH
• Yang SK
• Hong WS
• Kim JH
• Min YI

Abstract

BACKGROUND/AIMS
Barium defecography (BD) provides information about anorectal motion during defecation. However, BD involves radiation exposure and does not visualize the pelvic organs around the anorectum. Magnetic resonance (MR) defecography was introduced to overcome these shortages, however, its usefulness in pelvic floor dyssynergia remains uncertain. The aims of this study were to assess the utility of MR defecography and to characterize specific MR findings in pelvic floor dyssynergia (PFD).
METHODS
Twenty-four patients with PFD and 16 control subjects were included in the study. The patients with PFD underwent BD and dynamic MR defecography. Image analyse were acquired during rest (R), squeezing (S) and defecation (D). The control group received conventional pelvic MR.
RESULTS
(1) The changes in anorectal angle during R-> S and R-> D by MR were not significantly correlated with those of BD. (2) The anal canal thickness of patients with PFD was greater than that of the control group (18.98+/-2.43 vs. 15.33+/-1.41 mm, p<0.0001).
CONCLUSIONS
Dynamic MR defecography permits direct visualization of pelvic floor and perirectal structures in real time without exposing the patient to radiation. The anal canal thickening in MR defecography is a novel finding that may be attributed to PFD. However, futher study is needed to prove whether anal canal thickening is a causative factor of PFD.

Keyword

Chronic functional constipation; Pelvic floor dyssynergia; Dynamic MR defecography; Anal canal

MeSH Terms

Anal Canal
Ataxia
Barium
Constipation*
Defecation
Defecography*
Humans
Pelvic Floor
Barium