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

我们评价了2D和3D-MR直肠成像的临床应用价值，使用超快MR技术评估儿童肛门直肠畸形治疗后的粪便排泄情况。本研究纳入了10例肛门直肠畸形治疗后的儿童。分别使用turbo-FLASH和3D-FISP序列获得2D-MR图像和3D-MR图像。在注射OMR-2200后，在患者休息时、挤压期间、排出期间或最大拉紧时开始MR直肠造影。在2D-cine MR图像上，测量肛门直肠角、肛管宽度、提上睑肌吊带运动的时间变化。在2D电影图像上，注意到大便失禁患儿在休息和拉紧时肛门直肠角较宽，肛管扩张，提上睑肌吊带运动不良。在这些儿童中，体积分析显示挤压和拉伸之间没有显著差异。在8例保守治疗的患儿中，2例随访MR直肠造影显示治疗效果，我们的结论是，2D和3D-MR直肠造影提供了详细的生理信息，肛门直肠畸形治疗后的儿童肛门直肠管的条件。

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.