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Review
. 2022 Mar 20:87:e181-e185.
doi: 10.5114/pjr.2022.114866. eCollection 2022.

Magnetic resonance defecography findings of dyssynergic defecation

Nuray Haliloglu  1 , Ayse Erden  1
Affiliations
Review

Magnetic resonance defecography findings of dyssynergic defecation

Nuray Haliloglu et al. Pol J Radiol. .

Abstract

Dyssynergic defecation (DD) is defined as paradoxical contraction or inadequate relaxation of the pelvic floor muscles during defecation, which causes functional constipation. Along with the anal manometry and balloon expulsion tests, magnetic resonance (MR) defecography is widely used to diagnose or rule out pelvic dyssynergia. Besides the functional abnormality, structural pathologies like rectocele, rectal intussusception, or rectal prolapse accompanying DD can also be well demonstrated by MR defecography. This examination can be an uncomfortable experience for the patient, so the imaging method and the importance of patient cooperation must be explained in detail. The defecatory phase of the examination is indispensable for evaluation, and inadequate effort should be ruled out before diagnosing DD. MR defecography provides important data for the diagnosis of DD, but optimal imaging criteria should be applied. Further tests can be suggested if patient co-operation is not sufficient or MR defecography findings are irrelevant.

Keywords: MR defecography; anismus; dyssynergic defecation; pelvic floor.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

Figure 1
Figure 1
Rectal emptying can be assessed by measuring the maximum diameter of the contrast-filled rectum before (A) and after (B) defecatory attempts. Here we can see that most of the ultrasound gel is retained within rectum at the end of the examination
Figure 2
Figure 2
There is no change in anorectal angle on sagittal cine images at rest (A) and during defecation (B). This is a significant finding in the diagnosis of dyssynergic defecation
Figure 3
Figure 3
The impression of the puborectalis muscle on the anorectal junction during defecation causes a persistent narrowing (arrow). “Sandglasslike” appearance
Figure 4
Figure 4
On a sagittal cine image the impression of the puborectalis muscle on the anorectal junction (arrow), rectocele (asterisk), and minimal opening of the anal canal can be seen
Figure 5
Figure 5
Mild cystocele (< 3 cm) and “sandglass-like” appearance (arrow) are demonstrated during defecation
See this image and copyright information in PMC

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References

    1. Pisano U, Irvine L, Szczachor J, et al. . Anismus, physiology, radiology: is it time for some pragmatism? A comparative study of radiological and anorectal physiology findings in patients with anismus. Ann Coloproctol 2016; 32: 170-174. - PMC - PubMed
    1. Black CJ, Ford AC. Chronic idiopathic constipation in adults: epidemiology, pathophysiology, diagnosis and clinical management. Med J Aust 2018; 209: 86-91. - PubMed
    1. Kanmaniraja D, Arif-Tiwari H, Palmer SL, et al. . MR defecography review. Abdom Radiol (NY) 2021; 46: 1334-1350. - PubMed
    1. Lalwani N, El Sayed RF, Kamath A, Lewis S, Arif H, Chernyak V. Imaging and clinical assessment of functional defecatory disorders with emphasis on defecography. Abdom Radiol (NY) 2021; 46: 1323-1333. - PubMed
    1. Bharucha AE, Wald A, Enck P, Rao S. Functional anorectal disorders. Gastroenterology 2006; 130: 1510-1518. - PubMed