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Scintigraphic defecography: quantitative and dynamic assessment of anorectal function
R Hutchinson1, A B Mostafa, E A Grant
1Department of Surgery, Queen Elizabeth Hospital, Birmingham, United Kingdom.
Diseases of the Colon and Rectum
|December 1, 1993
Summary
Scintigraphic defecography offers a dynamic, quantitative assessment of anorectal function with lower radiation exposure than traditional methods, aiding in diagnosing fecal incontinence and constipation.
Area of Science:
- Gastroenterology
- Nuclear Medicine
- Radiology
Background:
- Conventional defecating videoproctography for anorectal function assessment is limited by its semiquantitative nature and high radiation exposure, restricting its use for prolonged or repeated testing.
- Objective and dynamic evaluation of anorectal function is crucial for diagnosing conditions like fecal incontinence and chronic constipation.
Purpose of the Study:
- To develop and evaluate a dynamic scintigraphic defecography method for assessing anorectal function.
- To provide a quantitative alternative to videoproctography with reduced radiation exposure.
Main Methods:
- Scintigraphic defecography was performed on 14 patients with fecal incontinence, 18 with chronic constipation, and 8 controls.
- A technetium-99m-radiolabeled artificial stool was introduced into the rectum, followed by gamma camera imaging during evacuation.
Main Results:
- Mean evacuation rates differed significantly between incontinent (2.8%/sec) and constipated (0.9%/sec) patients (P < 0.001).
- Quantitative data on rectal evacuation, anorectal angles, and pelvic floor movement were obtained.
- Scintigraphic defecography demonstrated significantly lower radiation doses to pelvic organs compared to videoproctography.
Conclusions:
- Scintigraphic defecography provides objective and dynamic assessment of anorectal function.
- This method is proposed as the investigation of choice for evaluating anorectal disorders.
- The technique offers quantitative insights and reduced radiation exposure, making it suitable for repeated assessments.