8th Baltic Congress of Radiology

Abdominal Radiology

poster abstract

The educational objectives of this poster is to share our personal firsthand experience with MR defecography, to inform people about technical and metodological details of the exam, improve knowledge about most common indications and clinical findings.

Patient preparation, sequences acquisition, interpretation and reporting of MR imaging are in line with ESUR and ESGAR Pelvic Floor Working Group recommendations. MR imaging was performed with a Philips Ingenia Ambition x 1,5T MR imaging system in supine position with elevated knees. A rectal cleansing enema prior to the examination was used to improve quality of imaging. To distend the rectum ultrasound gel was used Static high resolution T2-weighted images were taken at rest in three planes while dynamic T2 imaging during squeezing, straining and evacuation were taken only in sagittal plane.

MR defecography as a standardized clinical examination started only in January 2022 at our institution. The most common indications for MR defecography were obstructive defecation, pelvic organ prolapse, anal incontinence, urinary incontinence, urinary obstruction. Of the 10 patients evaluated, 8 were female and 2 were male. 9 patients suffered from significant II grade pelvic floor relaxation. Most of the patients had varying grade of pelvic organ prolapse: 8 patients had varying grade of cystocele, II grade uterine prolapse was found in 1 patient, 2 patients had rectal prolapse, noteworthy II grade rectocele was found in 1 patient. In additional, anal sphincter defects and atrophy were identified in 5 patients.

Functional disorders of the pelvic floor are common but usually complex conditions which often significantly affect the quality of life and manifest in a variety of symptoms. Almost all of our examined patients had complex pathology which involved multiple pelvic compartments and half of them had structural defects on static MR images, which might influence the choice of the prospective treatment and surgical technique.

Functional disorders of the pelvic floor are common but usually complex conditions which usually involves multiple pelvic compartments. The educational objectives of this poster is to share our personal firsthand experience with MR defecography, to inform people about technical and metodological details of the exam, improve knowledge about most common indications and clinical findings.

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