Relationship between MRI findings after laparoscopic?assisted anorectal pull?through for anorectal malformations and the functional outcomes
10.3760/cma.j.issn.1005?1201.2019.06.012
- VernacularTitle:先天性肛门直肠畸形经腹腔镜辅助肛门成形术后MRI表现与排便功能的关系
- Author:
Ran TAO
1
;
Qi LI
;
Xinyu YUAN
;
Long LI
;
Zhenhua BAI
;
Haixia LIU
Author Information
1. 首都儿科研究所附属儿童医院放射科
- Keywords:
Rectum;
Anus diseases;
Laparoscopes;
Magnetic resonance imaging
- From:
Chinese Journal of Radiology
2019;53(6):502-506
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the relationship between MRI findings and defecation function after laparoscopic?assisted anorectal pull?through for anorectal malformations. Methods A retrospective cohort study focused on the findings of MRI performed after laparoscopic?assisted anorectal pull?through for anorectal malformations and no spinal deformity was present in all patients who are currently older than 3 years. Forty?two patients aged from 3 to 16 years (median age was 4 years), whom accepted operation at 3 months to 13 years old(median age was 5 months), and MRI was carried out in 2 to 5 months after operation (median time was 3 months). The MRI manifestations including the relationship between the anorect and the high muscle complex(RAHMC), anorectal angle(AA); the relationship between the anorect and the low muscle complex(RALMC), the rectal maximum diameter(RMD), the fat tissue interposition(FTI) and the development of pelvic floor muscle(PFM) were reviewed and summarized. Statistically, the differences of MRI manifestations in different defecation function index, including the degree of voluntary bowel movements, soiling, constipation and Krickenbeck score were evaluated respectively with Chi?square test or rank sum test. Results statistically, There was significant differences among the groups with different degree of voluntary bowel movements, soiling and Krickenbeck score in the RAHMC (P<0.05), and AA was correlated with the degree of voluntary bowel movements, soiling, constipation and Krickenbeck score(P<0.05), but no significant differences was found among the groups with different defecation function index in the RALMC, the RMD, the FTI and the development of PFM(P>0.05). Conclusions The deviation of the anorect from the high muscle complex which showed in the postoperative MRI pictures suggested the poor prognosis, and well?developed pelvic floor muscles which indicated in the MRI was not the sufficient predictor for good outcome. Postoperative anorectal angle obtained in the MRI can be used as an objective indicator of prognosis.
