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High-resolution anorectal manometry and dynamic pelvic magnetic resonance imaging are complementary technologies. | LitMetric

AI Article Synopsis

  • Dynamic pelvic magnetic resonance imaging (DP-MRI) provides detailed insights into pelvic organ structure and function, but its use can be limited due to accessibility issues.
  • This study analyzed the relationship between high-resolution anorectal manometry (HR-ARM) results and findings from DP-MRI in patients with constipation, revealing that only intrarectal pressure showed a weak correlation with the size of rectocele and degree of pelvic organ prolapse.
  • The study concluded that HR-ARM and DP-MRI offer complementary information about pelvic conditions, as no significant correlations were found between most HR-ARM parameters and structural defects identified by DP-MRI.

Article Abstract

Background And Aim: Dynamic pelvic magnetic resonance imaging (DP-MRI) offers a comprehensive evaluation of pelvic organ structure in addition to functional information regarding evacuation. Opportunity to apply this technology can be limited due to regional lack of availability. Ideally, clues from standard anorectal testing could predict abnormalities on DP-MRI, leading to its efficient use. The aim of this study is to determine whether high-resolution anorectal manometry (HR-ARM) correlates with findings on DP-MRI.

Methods: This is a retrospective study of HR-ARM performed on patients with constipation who also underwent DP-MRI. Studies were reviewed for significant findings including posterior pelvic organ prolapse, rectocele > 3 cm, rectal intussusception, and anorectal angle. Statistical analysis was performed using Pearson's correlation coefficient, Student's t-test, and Fisher's exact test.

Results: Twenty-three patients undergoing HR-ARM (age range 25-78) also underwent DP-MRI. All were female; 76% were Caucasian. Twenty had significant structural findings: small pelvic prolapse (n = 2), moderate pelvic prolapse (n = 10), large pelvic prolapse (n = 9), rectocele (n = 8), or rectal intussusception (n = 3). Only intrarectal pressure on HR-ARM weakly correlated with size of rectocele (r = 0.46; P = 0.03) and degree of pelvic organ prolapse (r = 0.48; P = 0.02). The remainder of the HR-ARM parameters did not significantly correlate with DP-MRI findings. Patients with dyssynergy were not more likely to have rectoceles > 3 cm (44.4% versus 35.7%; P = 0.5) or large prolapses (44.4% versus 50%, P = 1.0), compared with those without dyssynergy, on HR-ARM.

Conclusion: We were unable to find a correlation between HR-ARM findings and structural pelvic defects on DP-MRI. Therefore, these two technologies provide complementary information in the evaluation of defecatory dysfunction.

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Source
http://dx.doi.org/10.1111/jgh.12697DOI Listing

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