Dynamic pelvic three-dimensional computed tomography for investigation of pelvic abnormalities in patients with rectocele and rectal prolapse.
BACKGROUND
Dynamic three-dimensional computed tomography (D-3DCT: high-speed helical scanning during defecation) was used for morphological evaluation of intrapelvic structures in patients with rectal prolapse and rectocele.


METHODS
Twenty-five patients with rectal prolapse or rectocele diagnosed by conventional defecography (CD) or clinical findings were additionally investigated with D-3DCT. D-3DCT images were acquired using a multislice CT system with a 16-row detector during simulated defecation. Helical scanning was performed with a slice thickness of 1 mm, a helical pitch of 15 s/rotation, and a table movement speed of 35 mm/s. The contrast medium, 100 ml of iopamidol (370 mg/ml), was injected at a rate of 2.5 ml/s to enhance contrast with other structures, and scan start was triggered by using a function for automatically determining the optimal scan timing.


RESULTS
Among the eight patients with rectocele, additional intrapelvic disorders were diagnosed in five (enterocele, 4; cystocele, 1; and uterine prolapse, 1) with D-3DCT. In the 17 patients with rectal prolapse, concomitant intrapelvic disorders were found in six (intussusception, 3; cystocele, 2; uterine prolapse, 2; rectocele, 1; and vaginal prolapse, 1).


CONCLUSIONS
D-3DCT can be a useful diagnostic tool for investigation of pelvic pathology in patients with rectocele and rectal prolapse.
Okamoto
Norihiro
N
Department of Surgery, Rokuwa Hospital, Heiwa, Inazawa 490-1323, Japan.
Maeda
Koutarou
K
Kato
Ryoichi
R
Senga
Shyoshi
S
Sato
Harunobu
H
Hosono
Ryuji
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D052858:Cystocele / Q000150:complications / Q000000981:diagnostic imaging; D019841:Defecography; D005260:Female; D006547:Hernia / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D021621:Imaging, Three-Dimensional; D007443:Intussusception / Q000150:complications / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000000981:diagnostic imaging*; D012002:Rectal Diseases / Q000150:complications / Q000000981:diagnostic imaging; D012005:Rectal Prolapse / Q000150:complications / Q000000981:diagnostic imaging*; D020047:Rectocele / Q000150:complications / Q000000981:diagnostic imaging*; D036542:Tomography, Spiral Computed; D014596:Uterine Prolapse / Q000150:complications / Q000000981:diagnostic imaging