The use of dynamic MR imaging in patients with clinical pelvic floor disorders.

Abstract

To determine the differences and challenging aspects of dynamic magnetic resonance defecography (MRD) compared to conventional defecography (CD) in diagnostic of clinical symptomatic pelvic floor dysfunction. Fifty patients (44 females, 6 males; mean age: 57years) with symptomatic pelvic floor dysfunction underwent both examinations, CD and MRD. Results were retrospectively intra-individual and interindividual evaluated in this multicentre study. Visibility and accuracy in diagnosis and classification of rectal prolapse, rectocele, enterocele, sigma diverticula and Cul-de-sac phenomenon/syndrome were observed. Differences were analysed using Mann-Whitney U test. P-values<0.05 were considered as statistically significant. CD was significantly superior to MRD in diagnosis and grading of rectal prolapse (p<.001), diagnosis and metric measurements of rectoceles (p=.016), diagnosis of elongated sigmoid colon (p=.008) and Cul-de-sac phenomenon and syndrome, respectively (p=.015; p=.008). MRD revealed equal results to CD in detection, localization, tendency to retention and enlargement of rectoceles (p=.337) and findings of enteroceles (p=.604) as well as sigma diverticula (p=.149). The complementary use of both examination methods, CD and MRD, is important to achieve a comprehensive look on every aspect of pelvic floor disorders and gain optimal results in detection and evaluation of all major disorders of the pelvic floor.