[Morphologic evaluation of fecal incontinence by magnetic resonance imaging in patients with corrected anal atresia].
OBJECTIVE
To describe the findings obtained with magnetic resonance imaging (MRI) in patients with ano-rectal atresia, after treatment by posterior sagittal anorectoplasty (PSARP), who have fecal incontinence and to describe its usefulness in the evaluation of causes of incontinence.


METHODS
Twelve patients, 9 men and 3 women, with anorectal atresia were examined with 0.5T MRI after performing PSARP for imperforate anus. The study included T1-weighted, T2-weighted and proton-density, axial, sagittal and coronal planes. The location of descended neorectus and the degree of development of pelvic musculature were evaluated.


RESULTS
Normal development of anus levator muscles and sphincterian complex were observed in six patients, with correct situation of neorectus between anus levator muscles and sphincterian complex in five of them and eccentric in the other one. Diverse grades of striate muscular complex underdevelopment were showed in the other six cases, moderate grade in four of them and severe hypoplasia in the other two. Spinal and urogenital congenital anomalies were found in these patients. Sagittal and coronal T1-weighted MR images were the most useful planes in evaluating the relationship between anus levator muscles and sphincterian complex and axial T1-weighted MR images in the evaluation of the level of development of striated muscle complex in the evaluation of patients.


CONCLUSIONS
MRI is useful in the evaluation of patients with fecal incontinence after performing PSARP for anorectal atresia. Unsuitable neorectus position or striated muscle complex hypoplasia are causes of postoperative incontinence in these patients.
Ros Mendoza
L H
LH
Servicio de Radiología, Hospital Universitario Miguel Servet, Zaragoza, Spain. lhros@wanadoo.es
Sarría Octavio de Toledo
L
L
Martínez Mombila
E
E
Elías Pollina
J
J
D000293:Adolescent; D000328:Adult; D001006:Anus, Imperforate / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D002648:Child; D005242:Fecal Incontinence / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009130:Muscle, Smooth / Q000473:pathology / Q000503:physiopathology; D012007:Rectum / Q000033:anatomy & histology* / Q000473:pathology* / Q000601:surgery