Value of magnetic resonance defecography (mrd) in the diagnosis of obstructed defecation syndrome (ods)

Abstract

Objectives: to describe the clinical features and images of MR defecography in patients with obstructive defecation syndrome, afterward evaluating the value of MR defecography in the diagnosis of obstructive defecation syndrome. Subjects and methods: cross-sectional study, 33 patients were diagnosed with obstructive defecation syndrome according to ROME IV criteria, were assigned to have MR defecography at Saint Paul General Hospital, during the period of study from January 2019 to July 2022. Results: About the general characteristics of the study group: mainly in women with 84,8%, the average age is 63.5 ± 12.5 years old. Rectocele is the most commonly detected lesion on clinical examination, with 12/33 cases, accounting for 36.4%. About image characteristics on pelvic floor dynamic MRI: the mean value of H line in normal phase is 4.7 ± 0.9cm, in strain phase is 5.9 ± 1.5cm. The mean value of the M-line in normal phase is 2.0 ± 0.2 cm, and 4.1 ± 0.3 cm in strain phase. Rectocele is the most common lesion, accounting for 63.6%. The detection rate of rectocele and associated lesions (cystocele, uterus descent, cervical descent, vaginal descent) on MR defecography is higher than that on clinical examination, the difference was statistically significant with p<0.05. Conclusion: Our study contributes to clarifying the high applicability of MR defecography in diagnosing the causes and grading of pelvic floor prolapse, pelvic organ prolapse in patients with obstructive defecation syndrome, combined with clinical symptoms to help clinicians make appropriate treatment indications for each patient.