Magnetic resonance defecography versus clinical examination and fluoroscopy: a systematic review and meta-analysis

Ramage, Lisa; Simillis, Constantinos; Yen, Clarence; Lutterodt, C.; Qiu, Shihui; Tan, Emile; Kontovounisios, Christos; Tekkis, Paris

doi:10.1007/s10151-017-1704-y

Cited by 32 publications

(14 citation statements)

References 42 publications

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“…Other exams have been evaluated as dynamic MRI. As this exam is poorly correlated to patient-reported symptom severity (69,70), its place is restricted to patients with an externalized or suspected prolapse.…”

Section: Functional Approachmentioning

confidence: 99%

Ultimate Functional Preservation With Intersphincteric Resection for Rectal Cancer

Collard

Lefèvre

2020

Front. Oncol.

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The proximity of the very low rectum rectal cancer to the anal sphincter raises a specific problem: how and until when can we preserve the anal continence without compromising the oncological result of the tumor resection? In this situation, intersphincteric resection (ISR) offers an excellent alternative to abdominoperineal resection (APR), but the selection of patients for this option must be extremely precise. This complex choice justifies the simultaneous consideration of an oncological approach with a functional approach in order to provide a full benefit to the patient. When a circumferential resection margin of at least 1 mm can be performed with a distal resection margin of at least 1 cm with or without preoperative radiotherapy, ISR ensures a safety choice. The oncological results of ISR reported in the literature when performed properly found a 5-year disease-free survival of 80.2% with a local recurrence rate of only 5.8%. In parallel to this oncological evaluation, the expected post-operative functional outcome and the resulting quality of life must be properly assessed pre-operatively, since partial or total resection of the internal sphincter impacts significantly on the functional outcome. Based on data from the literature, this work reports the essential anatomical considerations and then the oncological and functional elements indispensables when an anal continence preservation is evoked for a tumor of the very low rectum. Finally, the precise selection criteria and the major surgical principles are outlined in order to guarantee the safety of this modern choice for the patient.

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Section: Functional Approachmentioning

confidence: 99%

Ultimate Functional Preservation With Intersphincteric Resection for Rectal Cancer

Collard

Lefèvre

2020

Front. Oncol.

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“…Dynamic defecography has many advantages in helping us to understand the pelvic floor movement [16][17][18] . Some authors used dynamic MR defecography for evaluating the pelvic floor disease but MR defecography is expensive and not very convenient clinically.…”

Section: Discussionmentioning

confidence: 99%

A New Dynamic Echodefecography (EDF) Established by Using BK Ultrasound 8838 Transducer and its Testing Results Comparison with X-ray Defecography

Jin

Zhang

2020

Preprint

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Objective: To describe a new dynamic echodefecography(EDF) using BK ultrasound 8838 transducer and compare its testing results with X-ray defecography. Method: The BK 8838 ultrasound probe is used to evaluate the static 3D scan, dynamic 3D scan and dynamic 2D scan of pelvic floor and compare its testing results with X-ray defecography and defined its value to evaluate the pelvic floor disease. Results: Fifty-seven patients were studied (24 male and 33 female). Forty seven patients were diagnosed as anismus by EDF and 46 patients were diagnosed as anismus by X-ray defecography. Sixteen patients were diagnosed as rectocele by X-ray defecography , among which eight were classified as mild (6-15mm), 4 as moderate (16-30mm) and 4 as severe (over 30mm). Fourteen patients with constipation and 2 patients with anal pain were diagnosed as intussusception by EDF, but only 3 patients were diagnosed as intussusception by X-ray defecography. Two patients with constipation were diagnosed as perineal descent by EDF and none by X-ray defecography. Two patients were diagnosed as enterocele by EDF as well as X-ray defecography. Conclusion: The EDF established by BK 8838 ultrasound probe can show clear anatomy and real time movement of pelvic floor muscle. The EDF is more sensitive to the diagnosis of intussusception, perineal descent(PD) and anal spincter defect than X-ray defecograpgy. For anismus,rectocele and enterocele,the diagnosis results are comparable between EDF and X ray defecography. Further study is needed to determine its clinical values to evaluate the pelvic disease .

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“…It has been recognised that with MRI alone, rectoceles, intussusception and perineal descent may be missed 58 and it can be difficult to demonstrate complete emptying of the rectal ampulla, hence some centres perform both fluoroscopic and MRI examinations to evaluate the anatomy and function in a complementary fashion. It is likely that these limitations of MRI could be overcome by imaging the patient in a more physiological sitting position, and although there have been promising studies of sitting patients in open-magnet MR units, [59][60][61] the patient numbers are low and further studies are required.…”

Section: The Case Of Mri Defecographymentioning

confidence: 99%

Will MRI of gastrointestinal function parallel the clinical success of cine cardiac MRI?

Hoad

Clarke

Marciani

et al. 2018

The British Journal of Radiology

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How cine MRI entered clinical practice in the cardiac field MRI has always been an attractive imaging modality for the evaluation of cardiac morphology and function. 1 Cardiac MRI has the advantage that both cardiac and respiratory motion are generally periodic and relatively easily monitored, albeit indirectly, through synchronisation to the subjects' electrocardiogram (ECG) and the use of respiratory bellows. However, it only took a few years after the development of commercial MRI systems for functional cardiac imaging to be developed, with ECG-gated cine imaging first reported in 1988. 2

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Magnetic resonance defecography versus clinical examination and fluoroscopy: a systematic review and meta-analysis

Abstract: MRD has a role in the assessment of pelvic floor dysfunction. However, clinicians need to be mindful of the risk of underdiagnosis and consider the use of additional imaging.

Cited by 32 publications

References 42 publications

Ultimate Functional Preservation With Intersphincteric Resection for Rectal Cancer

Ultimate Functional Preservation With Intersphincteric Resection for Rectal Cancer

A New Dynamic Echodefecography (EDF) Established by Using BK Ultrasound 8838 Transducer and its Testing Results Comparison with X-ray Defecography

Will MRI of gastrointestinal function parallel the clinical success of cine cardiac MRI?

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