Studies on Accurate Differentiation of Dyssynergic Defecation Patients from Normal Subjects Based on Abnormal Anorectal Angle in MR Defecography

Using MR defecography, we investigated the kinematic indices of the pelvic floor, anorectal angle, and perineal descent, as well as the differences in movement, in dyssynergic defecation patients compared to healthy controls.

Methods: This study included twenty-two people with dyssynergic defecation constipation and fourteen stable asymptomatic people. In patients and healthy subjects, four complex pelvic floor MRI indices were measured: paradox (unusual shift of anorectal angle), perineal descent during straining, perineal ascent, and narrowing of anorectal angle during squeeze.

Results: With an R2 value near 1, the Paradox Index had the highest sensitivity (95.45%) and accuracy (92.86%) for detecting dyssynergic defecation (0.902). Other indices’ sensitivity and specificity were low, so no major change could be made by combining them with the Paradox Index. In the Paradox Index, only the Negative Predictive Value (92.85%) and Positive Predictive Value (95.45%) were large.

Conclusion: The best result of MR defecography for distinguishing dyssynergic defecation patients from healthy controls was the Paradox Index. As a result, MR defecography may be used as an authentic method to show patients the paradoxical role of the pelvic floor muscles, which could help them imagine the proper defecation pattern during their care.

Author (s) Details

Afsaneh Nikjooy
Department of Physical Therapy, Iran University of Medical Sciences, Iran.

Nader Maroufi
Department of Physical Therapy, Iran University of Medical Sciences, Iran.

Esmaeil Ebrahimi
Department of Physical Therapy, Iran University of Medical Sciences, Iran.

Homayoun Hadizadeh Kharazi
Department of Radiology, Iran University of Medical Sciences, Iran.

Bahar Mahjoubi
Department of Surgery, Iran University of Medical Sciences, Iran.

Hamidreza Saligheh Rad
Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Iran.

View Book :- https://stm.bookpi.org/CDHR-V7/article/view/917

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