title: Prospective Comparison between two different magnetic resonance defecography techniques for evaluating pelvic floor disorders: air-balloon versus gel for rectal filling.
abstract: to prospectively compare two rectal filling techniques for dynamic MRI of pelvic floor disorders (PFD).
  
  
  
  Twenty-six patients with PFD underwent the two techniques during the same procedure, one based on rectal placement of a balloon-catheter filled with saline and air insufflation (air-balloon technique or AB); another based on rectal filling with 180 cc of gel (gel-filling technique or GF). The examinations were compared for assessment and staging of PFD, including rectal-descent, rectocele, cystocele, colpocele, enterocele, rectal invagination. Surgery and clinical examinations were the gold standard.
  
  
  
  AB showed sensitivity of 96 % for rectal descent, 100 % for both rectocele and colpocele, 86 % for rectal invagination and 100 % for enterocele; understaged 11 % of rectal descents and 19 % of rectoceles. GF showed sensitivity of 100 % for rectal descent, 91 % for rectocele, 83 % for colpocele, 100 % for rectal invagination and 73 % for enterocele; understaged 3.8 % of rectal descent and 11.5 % of rectoceles. Both techniques showed 100 % of specificity. Agreement between air-balloon and gel filling was 84 % for rectal descent, 69 % for rectocele, 88 % for rectal invagination, 84 % for enterocele, 88 % for cystocele and 92 % for colpocele.
  
  
  
  Both techniques allowed a satisfactory evaluation of PFD. The gel filling was superior for rectal invagination, the air-balloon for rectocele and anterior/middle compartment disorders.
  
  
  
  • A standardized MRI technique for assessing pelvic floor disorders is not yet established. • This study compares two MRI techniques based on different rectal filling: air-balloon versus gel. • Both MRI techniques proved to be valuable in assessing PFD, with good agreement. • Air-balloon technique is more hygienic and better tolerated than the gel-filling technique. • Gel was superior for rectal invagination, air-balloon for rectocele and uro-genital prolapses.
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy. francesca.maccioni@gmail.com.
authors.forename: Francesca
authors.initials: F
authors.lastname: Maccioni
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
authors.forename: Najwa
authors.initials: N
authors.lastname: Al Ansari
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Buonocore
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Mazzamurro
authors.affiliation: Department of Surgical Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome, VialeRegina Elena 324, Rome, Italy.
authors.forename: Marileda
authors.initials: M
authors.lastname: Indinnimeo
authors.affiliation: Department of Surgical Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome, VialeRegina Elena 324, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Mongardini
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Catalano
mesh_terms: D000328:Adult; D000368:Aged; D000388:Air; D003287:Contrast Media; D019841:Defecography / Q000379:methods*; D005260:Female; D005782:Gels; D006801:Humans; D007327:Insufflation / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D017773:Pelvic Floor / Q000473:pathology; D059952:Pelvic Floor Disorders / Q000000981:diagnostic imaging*; D056887:Pelvic Organ Prolapse / Q000000981:diagnostic imaging; D011446:Prospective Studies; D020047:Rectocele; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D005782:Gels
keywords: Dynamic magnetic resonance imaging; MR defecography; Pelvic floor disorders; Pelvic organ prolapse; Rectal contrast agents