[MRI Defecography - What is Important for Surgery of the Pelvic Floor?]

Abstract

MR-defecography plays a key role in imaging complex pelvic floor dysfunction. Simultaneous detection of multiple findings in a complex anatomical setting makes correct analysis and clinical interpretation challenging. Thorough understanding of this imaging technique is essential for pelvic floor surgeons in order to make proper use of its advantages in the diagnosis of pelvic floor pathologies. We have reviewed the scientific literature on MR-defecography from recent years to sum up the most important aspects concerning patients' selection and preparation, examination procedure, standardised reporting and the most important pathological findings for pelvic floor surgery. MR-defecography is performed using static as well as dynamic MR sequences of high spatial resolution with excellent soft tissue contrast. The detection of pathological findings (pelvic floor relaxation, pelvic floor descent, rectocele, enterocele, peritoneocele, intussusception, rectal prolapse, dyssynergistic defecation) must always be correlated with clinical symptoms. It can provide information that is missed by other imaging modalities and hence it can alter therapeutic strategies in the interdisciplinary cooperation of pelvic floor surgeons, urologists and gynaecologists.