MR-Defäkografie bei obstruktiven Defäkationsstörungen

Zusammenfassung

Getragen durch den demografischen Wandel nehmen obstruktive Defäkationsstörungen stetig zu. Morphologische und funktionelle Ursachen spielen ineinander und tragen zur Komplexität dieser Erkrankung bei, was sich darin widerspiegelt, dass oft mehrere Kompartimente des Beckenbodens betroffen sind. Durch Anwendung der MR-Defäkografie können simultan detaillierte Informationen über Morphologie und Funktion der Kontinenzorgane gewonnen werden. Damit unterstützt das Verfahren als integraler Baustein des diagnostischen Workups maßgeblich die präoperative Abklärung des Anorektums. Verglichen mit der konventionellen Defäkografie, kann als Nachteil der Methode die Aufnahmetechnik im Liegen interpretiert werden, was in Einzelfällen eine suffiziente Entleerung der Rektumampulle erschwert oder gar verhindert. Dieser inhärente Nachteil wird jedoch durch die hohe anatomische Detailauflösung, die multiplanare Darstellung, die einfache Durchführung und nicht zuletzt das Fehlen einer Strahlenexposition aufgehoben. Konsekutiv hat sich die MR-Defäkografie als ein Verfahren der ersten Wahl zur Klärung von anorektalen Entleerungsstörungen in der klinischen Routine etabliert.

Abstract

As a consequence of demographic changes, outlet obstruction represents an increasingly common disease. The presence and ample interactions of morphological and functional pathologies contribute to the complexity of pelvic floor dysfunction. Additionally, multiple compartments of the pelvic floor are frequently affected. MR defaecography allows for the simultaneous and detailed assessment of morphological as well as functional changes of the pelvic floor. Hence, this approach constitutes an integral part of the diagnostic work-up and preoperative evaluation of the anorectum. The supine patient position can be regarded as a drawback compared to conventional defaecography, as sufficient emptying of the rectum can be impaired or even rendered impossible in individual cases. This inherent disadvantage is, however, compensated by the high anatomic resolution, the possibility of multiplanar imaging, easy execution and especially the lack of ionising radiation. Consequently, MR defaecography is considered the method of choice for the routine evaluation of functional anorectal disorders.

Schlüsselwörter

Beckenboden - obstruktive Defäkationsstörung - MR-Defäkografie

Key words

pelvic floor - obstructive defaecation disorders - MR defaecography

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