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Experience of 4 Years with Open MR Defecography: Pictorial Review of Anorectal Anatomy and Disease¹

¹ From the Institute of Diagnostic Radiology, University Hospital Zurich, Switzerland. Recipient of a Certificate of Merit award for an education exhibit at the 2000 RSNA scientific assembly. Received November 9, 2001; revision requested December 13 and received February 27, 2002; accepted March 5. Address correspondence to P.R.H., MR Institute, Private Hospital Bethanien, Toblerstrasse 51, CH-8044 Zurich, Switzerland (e-mail: hilfiker@mri-roentgen.ch).

Functional disorders of the pelvic floor are a common clinical problem. Diagnosis and treatment of these disorders, which frequently manifest with nonspecific symptoms such as constipation or incontinence, remain difficult. Fluoroscopic x-ray defecography has been shown to aid in detection of functional and morphologic abnormalities of the anorectal region. With the advent of open-configuration magnetic resonance (MR) imaging systems, MR defecography with the patient in a vertical position became possible. MR defecography permits analysis of the anorectal angle, the opening of the anal canal, the function of the puborectal muscle, and the descent of the pelvic floor during defecation. Good demonstration of the rectal wall permits visualization of intussusceptions and rectoceles. Excellent demonstration of the perirectal soft tissues allows assessment of spastic pelvic floor syndrome and descending perineum syndrome and visualization of enteroceles. MR defecography with an open-configuration magnet allows accurate assessment of anorectal morphology and function in relation to surrounding structures without exposing the patient to harmful ionizing radiation.

© RSNA, 2002

Index Terms: Defecography, 757.12143, 757.12144, 757.1288 • Rectum, 757.92 • Rectum, abnormalities, 757.159, 757.73 • Rectum, MR, 757.12143, 757.12144, 757.1288

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