MR Defecography


MR Defecography

MRI of PELVIS WITHOUT CONTRAST 

INDICATION:
 [ ]

TECHNIQUE: 
MRI Defecography was performed with [ ] ml intrarectal gel and [ ]ml vaginal gel as intrluminal contrast. Multiplanar multisequential MRI of the pelvis was followed by dynamic multiplanar sequences during rest, Kegel maneuver (squeezing) and Valsalva maneuver as well as evacuation phase.

COMPARISON:
 [ ]

FINDINGS:

Technical Notes:
[• The patient was able to comply with all instructions for dynamic imaging.]
[• The patient was able / unable to completely evacuate the rectum.]

Pelvic Floor Anatomy:

• Perineal Body: [unremarkable]
• Urogenital Diaphragm: [unremarkable, symmetric]

Levator Ani:
• Ileococcygeus:
•	Right: [unremarkable, convex upward, no tear or atrophy]
•	Left: [unremarkable, convex upward, no tear or atrophy]
• Pubococcygeus: 
•	Right: [unremarkable, no tear or atrophy]
•	Left: [unremarkable, no tear or atrophy]

Puborectalis: 
•	Right: [unremarkable, no tear or atrophy]
•	Left: [unremarkable, no tear or atrophy]

Internal Sphincter: [unremarkable] 
Intersphincteric space: [unremarkable]

Pelvic Viscera:
• Uterus: [unremarkable]
• Ovaries: [unremarkable]
• Bowel Segments: [unremarkable]
• Other: [unremarkable]
Pelvic soft tissues: [unremarkable]
Bones: [unremarkable]

Pelvic Floor Abnomalities:

Anterior compartment prolapse:
[Absent]
[Maximum] [     mm] [below PCL]
[Maximum] [     mm] [below MPL]
[Stage] [ ]

Middle compartment prolapse:
[Absent]
[Maximum] [     mm] [below PCL]
[Maximum] [     mm] [below MPL]
[Stage] [ ]

Posterior compartment prolapse:
[Absent]
[Maximum] [     mm] [below PCL]
[Maximum] [     mm] [below MPL]
[Stage] [ ]

Cystocele: [Absent] [Size  cm]
Rectocele: [Absent] [Size  cm]
Enterocele: [Absent] [Size  cm]
Intussusception: [Absent] [ Mucosal ] [Full thickness ]
Evacuation: [Complete] [Incomplete]


IMPRESSION:
[ ]






Pelvic Floor Dynamics & Metrics (for research purposes):

Anorectal Angle(o)		 Rest [ ]   Kegel [ ]	Valsalva [ ]   Evacuation [ ]
			
Urethral Axis(o) 		 Rest [ ]   Kegel [ ]	Valsalva [ ]   Evacuation [ ]
				
H-Line				 Rest [ ]   Kegel [ ]	Valsalva [ ]   Evacuation [ ]

Bladder base to PCL	 Rest [ ]   Kegel [ ]	Valsalva [ ]   Evacuation [ ]

Anterior cervical lip to PCL 	              Rest [ ]   Kegel [ ]	Valsalva [ ]   Evacuation [ ]

Posterior Anorectal junction to PCL	              Rest [ ]   Kegel [ ]	Valsalva [ ]   Evacuation [ ]
(M-Line)

Bladder base to MPL 	          Rest [ ]   Kegel [ ]	Valsalva [ ]   Evacuation [ ]

Anterior cervical lip to MPL 	      Rest [ ]   Kegel [ ]	Valsalva [ ]   Evacuation [ ]

Anterior Anorectal junction to MPL		 Rest [ ]   Kegel [ ]	Valsalva [ ]   Evacuation [ ]


* Negative numbers indicate position below the reference line.

1) H-Line: Antero-posterior width of levator hiatus
2) PCL: Pubococcygeal Line
3) M-Line: Descent of levator hiatus
4) MPL: Mid Pubic Line

Reference for grading: http://www.ajronline.org/doi/pdf/10.2214/AJR.09.3670
Specialities
Genitourinary Radiology
Magnetic Resonance Imaging
Created
2016-05-20 10:38:41
Modified
2016-05-20 10:38:41
Views
1852
Downloads
17
Rating
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Language
English
Author
Khashayar Rafat Zand

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