Magnetic resonance imaging of anatomic and dynamic defects of the pelvic floor in XXXX .

@entity1 @entity3087 @entity194 @entity74 @entity1241
OBJECTIVE: Endoanal ultrasound identifies anal sphincter anatomy, and evacuation proctography visualizes pelvic floor motion during simulated defecation. These complementary techniques can evaluate obstructed defecation and @entity1241 . Our aim was to develop a single, nonionizing, minimally invasive modality to image global pelvic floor anatomy and motion. METHODS: We studied six @entity1 with @entity1241 and seven @entity1 with obstructed defecation. The anal sphincters were imaged with an endoanal magnetic resonance imaging (MRI) coil and endoanal ultrasound (five @entity1 ). MR fluoroscopy acquired images every 1.4-2 s, using a modified real-time, T2-weighted, single-shot, fast-spin echo sequence, recording motion as @entity1 squeezed pelvic floor muscles and expelled ultrasound gel; no contrast was added to other pelvic organs. Six @entity1 also had scintigraphic defecography. RESULTS: Endoanal ultrasound and MRI were comparable for imaging defects of the internal and external sphincters. Only MRI revealed puborectalis and/or external sphincter @entity194 ; four of these @entity1 had @entity1241 . MR fluoroscopy recorded pelvic floor contraction during squeeze and recorded relaxation during simulated defecation. Corresponding comparisons for angle change and perineal descent during defecation were not significant; only MRI, but not scintigraphy, identified excessive perineal descent in two @entity1 . CONCLUSIONS: Pelvic MRI is a promising single, comprehensive, nonradioactive modality to measure @entity3087 in @entity74 . This method may provide insights into mechanisms of normal and disordered pelvic floor function in health and disease.
