Evaluation of Pelvic Floor Dysfunction with Magnetic Resonance Defecography

Abstract

Introduction: The aim of this study is to reveal MR defecography findings of pelvic floor failure and to highlight the significant points regarding acquiring and interpreting images. Materials and Methods: The patients who underwent MR defecography imaging in our department between 2013 and 2016 were retrospectively evaluated. Abnormalities of pelvic compartments were both investigated and graded. Axial diameter of the levator hiatus and iliococcygeus angle were measured at rest and during straining and the measurements were compared. H line, M line and ARA were measured at rest, during straining and defecation and the measurements were compared. Results: There was a statistically significant difference between rest and straining, rest and defecation, straining and defecation phases in terms of the length of M and H lines. Changes in the transverse diameter of levator hiatus and iliococcygeus angle between rest and straining phases were statistically significant. In the patients without spastic pelvic floor syndrome, there was a statistically significant difference between rest and straining, rest and defecation, straining and defecation phases in terms of ARA. In the patients with spastic pelvic floor syndrome, changes in ARA between rest and straining, rest and defecation phases were statistically significant. There was no statistically significant difference between straining and defecation phases in terms of ARA. Conclusion: MR defecography gives detailed information about pelvic compartment abnormalities in the patients with pelvic floor failure. While early images of defecation are more useful for the assessment of the posterior compartment, late phase images would allow more accurate definition of anterior and middle compartment abnormalities. Keywords: MR defecography, pelvic floor dysfunction, spastic pelvic floor syndrome