Pelvic floor experts issue new recommendations for magnetic resonance defecography

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Magnetic resonance defecography (MRD) has emerged as a powerful, non-invasive imaging technique to assess the many possible causes of problems in the passage of stool. A new set of consensus recommendations for achieving and interpreting MRD results has been published by Diseases of the colon and rectum (DC&R), the official journal of the American Society of Colon and Rectal Surgeons (ASCRS).

The recommendations were developed by the Pelvic Floor Disorders Consortium (PFDC), a multidisciplinary organization representing the wide range of professionals involved in the diagnosis and treatment of pelvic floor disorders. The new recommendations are now available on the DC&R website and appear in the October issue of the journal. Liliana Bordeianou, MD, MPH, of the Massachusetts General Hospital Pelvic Floor Disorders Center and Harvard Medical School was the lead author of the consensus statement.

Recommendations include consensus definitions and interpretive models for DRM

Magnetic resonance defecography is a special type of MRI scan that provides detailed, high-contrast images of the complex anatomy of the pelvic floor. Images are obtained at different stages of defecation, providing detailed information for doctors to diagnose the cause of incontinence, constipation, pelvic organ prolapse, and other conditions that interfere with the ability to pass stool . Compared to other tests, the MRD provides both functional and structural information in patients with symptoms of defecation dysfunction

Previous guidelines for performing MRD lacked input from many specialties including colon and rectal surgeons, gynecologists, radiologists, urologists, and others involved in the diagnosis and treatment of pelvic floor disorders. Differences between and among specialties can cause variations in how physicians interpret and use MRD results. This is of particular concern in the management of patients with pelvic floor disorders, who often present with complex symptoms and consult several different professionals.

The recommendations were developed “for the explicit purpose of inviting and including representatives from all relevant clinical specialties for which MRD is of clinical importance,” according to the new release. The PFDC working group included an international roster of 24 multidisciplinary experts, who went through a formal process to develop and endorse consensus recommendations in key areas.

The recommendations address important factors in performing the MRD technique, including patient positioning and the use of contrast media to provide high-quality images of pelvic floor anatomy and function. The working group stresses the importance of education and coaching to ensure that patients understand and can follow the maneuvers necessary to perform the exam.

The new document includes recommendations for the interpretation of MRD scans, allowing the identification and classification of any abnormalities: for example, pelvic floor muscle movement problems (dyssynergy) or abnormalities interfering with bowel movement. (such as rectocele, intussusception or rectal prolapse).

Figures and videos illustrating the MRD aspect of these results are included in the print and online versions of the new document. The report also presents a standard model for reporting the results and interpretation of the MRD, with the aim of promoting a shared understanding and better communication among all professionals involved in the care of patients with pelvic floor disorders. Approved by six national and international medical societies, including ASCRS, the consensus statement is published simultaneously in four leading trade journals.

“The goal of this effort was to create a universal set of guidelines and language for technique, interpretation, and MRD reporting that can be used and have the same meaning in all disciplines,” conclude Dr. Bordeianou and his colleagues. co-authors. Although the recommendations are not exhaustive, they “should be advocated as minimum requirements when performing and interpreting MRD in patients with pelvic floor evacuation disorders”.


Publication of consensus definitions and interpretive models for MRI of pelvic floor defecation disorders


More information:
Brooke H. Gurland et al, Consensus Definitions and Interpretive Models for Magnetic Resonance Imaging of Pelvic Floor Defecation Disorders, Colon and rectal diseases (2021). DOI: 10.1097 / DCR.0000000000002155

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Quote: Pelvic Floor Experts Issue New Recommendations for Magnetic Resonance Defecography (2021, September 23) Retrieved September 23, 2021 from https://medicalxpress.com/news/2021-09-pelvic-floor-experts-issue- magnetic.html

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