摘要
目的探讨动态MR排粪造影在出口梗阻型便秘影像学评价中的优势与不足。方法从412例出口梗阻型便秘患者的改良X线排粪造影资料中选择合适病例72例,进行动态MR排粪造影检查,对比研究X线和MR排粪造影图像;根据经验对动态MR排粪造影的检查技术作出优化调整。结果412例X线排粪造影阳性率为58.5%,其中横结肠冗长26例(6.3%),脾曲综合征19例(4.6%),结肠张力偏低21例(5.1%),明确盆腔及盆底疾病154例。选择适合行动态MR排粪造影者72例中,发现直肠黏膜脱垂12例(16.7%),直肠前膨出9例(12.5%),耻骨直肠肌疾病9例(12.5%),会阴下降综合征21例(31.8%),直肠黏膜内套叠8例(11.1%),其他器质性疾病8例(11.1%),盆底疝7例(10.6%)。结论动态MR排粪造影对盆腔和盆底疾病引起的出口梗阻型便秘的诊断及分型是X线排粪造影的很好补充,并对临床治疗方式的选择有很好的指导价值,但检查体位限制影响了与重力相关的盆底疾病的检出率,宫内节育环存在限制了其作为排粪造影的常规方式。
Objective To explore the advantages and limitations of dynamic MR defecography in outlet obstruction constipation.Methods 72 appropriate outlet obstruction constipation cases were selected from 412 improved defecography cases to accept the dynamic MR defecography.We compared the MR images with those of improved defecography,and optimized the inspection technique of dynamic MR defecography in our experience.Results The positive rate of improved defecopraphy in 412 cases is 58.5%,and we found 26（6.3%）cases with colon transversum lengthy;19（4.6%）cases with splenic flexure syndrome;21（5.1%）cases with colon tension lower.The pelvic cavity and pelvic floor diseases were definited in 154 cases.In 72 cases which took dynamic MR defecography,we found 12（16.7%）cases with rectal prolapse;9（12.5%）cases with anterior rectocele;9（12.5%）cases with puborectal muscle syndrome;21（31.8%）cases with descending perineal syndrome;8（11.1%）cases with rectal intussusception;8（11.1%）cases with other organic diseases;7（10.6%）cases with pelvic floor hernia.Conclusion The Dynamic MR defecography has good additions to improved defecography about outlet obstruction constipation in the diagnosis and typing.In addition,it is an important guideline for the choice of clinical treatment plans.The position will affect the detection rate about the diseases of the pelvic cavity and pelvic floor which correlation of gravity,and the IUD also may limit this exam to become a conventional way.
出处
《结直肠肛门外科》
2015年第3期165-170,共6页
Journal of Colorectal & Anal Surgery
基金
上海市浦东新区卫生计生委青年基金(PW2012B-5)
浦东新区传统型中医肛肠临床示范学科建设(PDZYXK-3-2013007)
浦东新区卫生系统重点学科群(PWZxq2014-13)
关键词
排粪造影
MR
出口梗阻型
便秘
Defecography
magnetic resonance imaging
Outlet obstruction
Constipation
