Abstracts
2002 Digestive Disease Week

# 103933 Abstract ID: 103933 Rectal Anatomy after Rectopexy for Emptying Disorder: Comparison of Conventional and MR Defecography
Martin J Utzig, Anton J Kroesen, Alix Oesterheld, Daniel Cornely, Karl-Jürgen Wolf, Heinz J Buhr, Berlin, Germany

Objective: Conventional defecography can reveal abnormalities like rectocele and intussusception in the majority of patients with emptying disorders. With the advent of open-configuration MR systems MR defecography has become possible. However, MR defecography has not been established as standard investigation yet. The aim of this study was to assess the correlation of conventional and MR defecography. Patients and methods: Between 01/95 and 06/01, 35 patients underwent abdominal sigmoidectomy and Well's rectopexy due to rectal emptying disorder. To assess results of surgical repair, all patients were investigated by conventional defecography postoperatively. 14 patients underwent MR defecography additionally. The defecographic results were screened for the anorectal angle, perineal movement, defined both at rest and during straining, and descensus of surrounding structures. The results of conventional defecography were compared with those of MR examination with the Friedman-test. Results: In general, with respect to anorectal angle and perineal motility, MR defecography revealed results consistent with those obtained by conventional defecography. In MR defecography, anorectal angle at rest was smaller when compared with conventional defecography, but there was no statistically significant difference during squeeze and defecation. Box plot analysis showed no significant discrepancy of the perineal movement at rest and during squeeze, but demonstrated an increased perineal descent in MR imaging. In 4 patients MR defecography visualized a descent of the bladder. However, in 4 patients with complete defecation in conventional examination MR defecography pretended deficient evacuation. Conclusion: At rest and during defecation, MR defecography reveals anorectal angles consistent with those obtained in conventional investigation. Perineal motility at rest and during squeeze is comparable to that defined in conventional defecography. The concomitant depiction of structures surrounding the anorectal canal in MR defecography is helpful in the assessment of descent of surrounding organs and permits visualization of enteroceles. However in 30% of patients MR defecography pretends incomplete defecation.