Clinical value of MR defecography: What additional knowledge is provided by the radiologist to the surgeon?

Autor: Colarieti A; Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. Electronic address: anna.colarieti@uniupo.it., Stuto A; Unit of Colonproctology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy., Cellerino P; Unit of Colonproctology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy., Sardanelli F; Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
Jazyk: angličtina
Zdroj: European journal of radiology [Eur J Radiol] 2024 Dec; Vol. 181, pp. 111760. Date of Electronic Publication: 2024 Sep 27.
DOI: 10.1016/j.ejrad.2024.111760
Abstrakt: Purpose: To evaluate the clinical value of MR defecography in supporting surgical decision-making and management strategies in a consecutive series of patients.
Material and Methods: A consecutive series of patients with clinical suspicion of pelvic disorders who underwent MR defecography at a single university hospital from January 2021 to June 2024 were included. MR defecography was performed at rest (axial/sagittal and coronal T2-weighted sequences), during squeezing, straining, and evacuation (dynamic sagittal T2-weighted sequences). An expert surgeon assessed his satisfaction about the diagnostic information given by the prospective radiological report as: 1: insufficient, 2: sufficient, 3: good, 4: excellent. For patients who underwent surgery, the same surgeon assessed the usefulness of the MR defecography, using a score from 1 to 4 (1: discordant findings, useless exam; 2: concordant findings without new information; 3: concordant findings, useful new information; 4: concordant findings, extremely useful new information).
Results: A total of 218 patients (age 27 - 79, mean 60 ± 11; 193 females and 25 males) entered the analysis. For 211 of them (97 %), the radiologist was able to evaluate the images and determine an MR defecography-based diagnosis; in 7 patients (3 %), a diagnosis was not provided due to exam interruption for low patient's compliance. In 195/211 patients (92 %), the radiological diagnosis matched the clinical suspect that prompted the examination. The satisfaction about the diagnostic information given by the radiological report of the 211 exams was assessed by the surgeon as follows: excellent (n = 99, 47 %), good (n = 48, 23 %), sufficient (n = 35, 16 %), and insufficient (n = 29, 14 %). Out of 211 patients, 73 (34.6 %) underwent surgery. MR defecography provided concordant findings with relevant additional information in 63 (86.3 %), concordant findings with additional information in 3 (4.1 %), concordant findings without additional information in 4 (5.5 %), and discordant findings in 3 (4.1 %).
Conclusions: The diagnostic information prospectively provided by MR defecography resulted to be good or excellent in 70 % of the patients, adding clinical value in the preoperative surgical setting in 86 % of those patients who underwent surgery.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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