Comparison of conventional and magnetic resonance defecography for diagnosis of outlet obstructive syndrome

Abstract

Background. Outlet obstruction syndrome refers to all pelvic floor dysfunctions that are responsible for incomplete evacuation of fecal contents from the rectum. Defecography is the first step for diagnosis of outlet obstruction syndrome. The free selection of imaging planes, good temporal resolution, and excellent soft tissue contrast has helped to transform this method into the preferred imaging modality for evaluation of patients with pelvic floor dysfunction. The purpose of our study was to compare conventional and magnetic resonance (MR) defecography in patients who were admitted for outlet obstruction syndrome. Materials and methods. Twenty-eight patients who presented with constipation between January 2015 and January 2020 were included in this study. MR defecography was performed 1 to 2 weeks after conventional defecography. The methods were compared with regard to their ability to diagnose anterior rectocele, internal mucosal intussusception with or without rectocele, and puborectal spasm. Additional abnormalities were also noted. Results. Comparison of conventional and MR defecography for their ability to diagnose anterior rectocele, internal mucosal intussusception, and puborectal spasm showed no significant differences between the 2 methods. The continuity correction ratio of the 2 methods for diagnosis of anterior rectocele, internal mucosal intussusception, and puborectal spasm was 0.146, 0.007, and 1.000, respectively. Conclusions. Although conventional defecography is the gold standard for diagnosis of rectocele, intussusception, and puborectal spasm, MR defecography has garnered considerable attention due to the lower radiation, increased safety, and higher incidence for diagnosis of another pathology, such as uterine diversion.