Evaluation of Continence after Treatment for Anorectal Anomalies with 2D-cine and 3D-volume MRI

我们评估了2D-和3D-MR直肠成像在评估儿童肛门直肠畸形治疗后大便可控性方面的临床应用价值。分别使用Turbo-Flash和3D-FISP序列获取2D和3D-MR图像。在注射OMR-2200后，开始对患者在静止、挤压、排气或最大张力状态下进行磁共振检查。从2D电影图像中测量肛门直肠角、肛管宽度、提肌吊带运动的时间变化。在2D电影图像上，大便失禁患儿的肛门直肠角较宽，在拉力时肛管扩张，提肌吊带运动不佳。在这些儿童中，容量分析显示挤压和拉伸之间没有显著差异。在8名接受保守治疗的儿童中，2名儿童获得了随访MR直肠造影的治疗效果。我们的结论是，2D-和3D-MR直肠造影提供了有关肛门直肠畸形治疗后儿童肛门直肠管情况的详细的生理学信息。

We evaluated the clinical usefulness of 2D- and 3D-MR proctography using a ultrafast MR technique for assessing the fecal continence in children after treatment for anorectal anomalies.1O children after treatment for anorectal anomalies were included in this study. A turbo-FLASH and a 3D-FISP sequences were used to acquire 2D-and 3D-MR images, respectively. After injecting of OMR-2200, MRproctogram was started with the patient at rest, during squeezing, and during expulsion or at maximum straining. From 2D-cine MR images, the temporal changes of the anorectal angle, the width of the anal canal, the movement of the levator sling were measured. From 3D-volume images, volumetric analysis were performed in each phase.On 2D-cine images, wide anorectal angle and dilatation of the anal canal at rest and during straining, and poor movement of the levator sling were noted in children with fecal incontinence. In these children, volumetric analysis showed no significant difference was present between squeezing and straining. Among 8 children on whom conservative treatment was performed, follow-up MR proctograhy showed therapeutic effects in 2 children.It was our conclusion that 2D- and 3D-MR proctography provides detailed, physiologic information about the conditions of anorectal canal in children after treatment for anorectal anomalies.