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

我们利用超快磁共振技术评估了2D和3D-MR直肠造影在评估儿童肛肠异常治疗后大便失禁的临床应用价值。本研究纳入了10名接受肛肠异常治疗的儿童。使用turbo-FLASH和3D-FISP序列分别获取2d和3D-MR图像。注射OMR-2200后，在患者静息、挤压、排液或最大张力时开始磁共振成像。从2d电影MR图像中，测量肛门直肠角的时间变化，肛管宽度，提肛吊带的运动。根据3d体积图像，在每个阶段进行体积分析。在2d电影图像上，大便失禁患儿在静息和拉扯时肛管角度宽，肛管扩张，提肛吊带运动不良。在这些儿童中，体积分析显示挤压和拉伸之间没有显着差异。保守治疗的8例患儿中，随访MR直肠造影显示2例患儿有治疗效果。我们的结论是，2D和3D-MR直肠造影提供了详细的生理信息，关于儿童肛肠异常治疗后的肛肠管状况。

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.