Comparison of High-Resolution Anorectal Manometry and Magnetic Resonance Defecography in Patients With Obstructive...

Area of Science:

• Gastroenterology
• Pelvic Floor Disorders
• Diagnostic Imaging

Background:

• Evacuation disorders are frequently investigated in patients with obstructive defecation symptoms.
• High-resolution anorectal manometry (HR-ARM) is a standard, accessible diagnostic tool for pelvic floor dysfunction.
• Magnetic resonance defecography (MRD) is a more advanced, less accessible imaging technique.

Purpose of the Study:

• To determine the added diagnostic value of magnetic resonance defecography (MRD) in patients with pelvic floor dysfunction.
• To compare findings from HR-ARM and MRD in patients diagnosed with constipation.
• To assess if MRD provides additional information beyond HR-ARM for guiding therapeutic recommendations.

Main Methods:

• A retrospective review identified 76 patients who underwent both HR-ARM and MRD for constipation between January 2020 and May 2022.
• Univariate and multivariate analyses compared MRD findings in patients with and without abnormal HR-ARM results.
• Statistical methods included Pearson's chi-square test for categorical variables and two-sample t-tests for continuous variables.

Main Results:

• Of 76 patients, 64.5% showed dyssynergia on HR-ARM.
• Patients with HR-ARM-diagnosed dyssynergia had significantly prolonged balloon and incomplete gel expulsion times on MRD (p < 0.001).
• However, HR-ARM-diagnosed dyssynergia did not correlate with a significantly higher likelihood of clinically significant rectocele (>2 cm) or rectal prolapse on MRD.

Conclusions:

• Anatomic findings on MRD were comparable between patients with and without HR-ARM-identified dyssynergia.
• In this cohort, simultaneous MRD did not offer significant additional diagnostic information to guide treatment decisions compared to HR-ARM alone.
• Further prospective research is necessary to definitively establish the added value of MRD in diagnosing pelvic floor disorders.