The diagnostic value of MRI fistulogram and MRI distal colostogram in patients with anorectal malformations.
Contrast fistulogram (FG) and distal pressure colostogram (DPCG) are standard diagnostic methods for the assessment of anorectal malformations. Pelvic magnetic resonance imaging (MRI) earned a place among essential diagnostic methods in preoperative investigations after the Currarino syndrome and a high incidence of associated spinal dysraphism were described. The aim of our study was to evaluate the possibility of substituting FG and DPCG by a modified pelvic MRI, e.g. MRI fistulogram (MRI-FG) and MRI colostogram (MRI-DPCG). The prospective study involved 29 patients with anorectal malformations who underwent a modified pelvic MRI. The length and course of fistulas and rectum, and the presence of sacral anomalies were studied on MRI images and compared with images obtained by radiologic examinations. Modified MRI brought identical results as contrast studies in 25 patients when related to the fistula and rectum length and course. MRI was more accurate for the detection of sacral anomalies. MRI-FG was the only imaging method used in the four most recent patients. The results support the assumption that conventional contrast examinations for the assessment of anorectal malformations can be replaced by MRI, thus reducing the radiation dose.
Department of Pediatric Surgery, 2nd Faculty of Medicine, Charles University and Faculty Motol Hospital, Prague, Czech Republic. Lucie.Kavalcova@fnmotol.cz
Lucie
L
Kavalcova
Richard
R
Skaba
Martin
M
Kyncl
Blanka
B
Rouskova
Ales
A
Prochazka
D000015:Abnormalities, Multiple; D001003:Anal Canal / Q000002:abnormalities* / Q000473:pathology; D000768:Anesthesia, General; D001004:Anus Diseases / Q000151:congenital / Q000175:diagnosis* / Q000601:surgery; D003125:Colostomy; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000601:surgery; D007412:Intestinal Fistula / Q000151:congenital / Q000175:diagnosis* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D010502:Perineum / Q000473:pathology; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D012003:Rectal Fistula / Q000151:congenital / Q000175:diagnosis / Q000601:surgery; D012006:Rectovaginal Fistula / Q000151:congenital / Q000175:diagnosis / Q000601:surgery; D012007:Rectum / Q000002:abnormalities* / Q000473:pathology; D012447:Sacrum / Q000002:abnormalities; D016135:Spinal Dysraphism / Q000175:diagnosis / Q000473:pathology; D014522:Urethral Diseases / Q000151:congenital / Q000175:diagnosis / Q000601:surgery; D001745:Urinary Bladder Diseases / Q000151:congenital / Q000175:diagnosis / Q000601:surgery; D014548:Urinary Fistula / Q000151:congenital / Q000175:diagnosis* / Q000601:surgery
D003287:Contrast Media
Anorectal malformations; Fistulogram; MRI; Pressure distal colostogram