Magnetic imaging defecography results are comparable to high-resolution manometry and conventional X-ray defecography in
- PDF / 959,200 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 43 Downloads / 120 Views
ORIGINAL ARTICLE
Magnetic imaging defecography results are comparable to high‑resolution manometry and conventional X‑ray defecography in the assessment of functional pelvic floor disorders D. Carter1,2 · O. Saukhat2,3 · M. Alcalay4,5 · N. Horesh2,6 · E. Ram2,6 Received: 20 May 2020 / Accepted: 2 July 2020 © Springer Nature Switzerland AG 2020
Abstract Background X-ray defecography or magnetic resonance defecography (MRD) and high-resolution anorectal manometry (HR-ARM) are essential for the diagnosis of pelvic floor disorders (PFD). However, there is only scarce information available about the accuracy of MRD in the functional assessment of the pelvic floor. The aim of this study was to examine the accuracy of MRD in the diagnosis of pelvic floor disorders by examining the intra-test agreement with x-ray defecography and HR-ARM in patients with PFD. Methods The study population included adults referred to our institution in January 2018–February 2020 for MRD as part of their evaluation of PFD. The MRD results were compared with X-ray defecography and HR-ARM. Results Forty-two patients were included in the study (36 female, 86%, mean age 56.9 years ± 15.8, range 19–86 years). When compared to X-ray defecography, the sensitivity of MRD for the evaluation of normal rest and squeeze pressures was high (0.83 and 1, respectively). High sensitivity rates were observed for the detection of pelvic organ prolapse and pelvic floor dyssynergia (0.84–1). When compared to HR-ARM, the sensitivity of MRD for the evaluation of squeeze and dyssynergia was very good (0.92and 1, respectively), and good for the evaluation of rest pressure (0.6). Inter-test agreement was high (0.5, 0.6, 0.6 for rest, squeeze and dyssynergia). Excellent rates of sensitivity as well as almost perfect intra-test agreement was found between abnormal balloon expulsion test and the diagnosis of dyssynergia and pelvic organ prolapse on MRD (1, 0.81). Conclusions This study demonstrated substantial diagnostic agreement between HR-ARM and MRD in the diagnosis of pathological etiologies for functional pelvic floor disorders, mainly obstructed defecation syndrome. Keywords Defecography · Magnetic resonance defecography (MRD) · Anorectal manometry · Pelvic floor dysfunction
Introduction * D. Carter [email protected] 1
Department of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer, Israel
2
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
3
Department of Radiology, Chaim Sheba Medical Center, Tel Hashomer, Israel
4
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel
5
Azrieli Faculty of Medicine at Galille, Bar Ilan University, Ramat Gan, Israel
6
Department of Surgery B, Chaim Sheba Medical Center, Tel Hashomer, Israel
Pelvic floor dysfunction (PFD) is a debilitating disorder seen frequently in the older population and often presents with a wide range of symptoms [1, 2]. Symptoms may include constipation, anal incontinence, a feeling of pressure or a bulge and pel
Data Loading...
