MRI Defecography

What is MRI Defecography?

MRI defecography, also known as MR defecography, is a special form of magnetic resonance imaging (MRI) test that captures detailed images of the pelvic region to help diagnose conditions involving the pelvic floor. The test helps physicians visualize the organs of the pelvis and the pelvic muscles, particularly during bowel movements.

The MRI defecography test is designed to provide insight into the function and structure of the pelvic floor muscles and a patient’s anorectal anatomy. The images produced can be important in helping deliver the accurate diagnosis needed to treat issues involving the pelvic region, including rectal prolapse, urinary and fecal incontinence and pelvic floor dysfunction.

What Medical Conditions Can an MRI Defecography Test Help Diagnose?

The MRI Defecography test can be instrumental in diagnosing a range of conditions, including:

  • Pelvic organ prolapse: A condition in which a pelvic organ like the bladder or uterus can drop from their original locations due to weak muscles or supporting tissues
  • Pelvic floor dysfunction: a disorder in which patients have difficulty relaxing their pelvic floor muscles during a bowel movement
  • Urinary or fecal incontinence: the unintended release of urine or stool
  • Rectal prolapse: a condition in which the rectum’s lining slips outside the anus
  • Descending perineal syndrome: a condition in which the perineum — the area between the anus and genitalia — can bulge outward during any kind of straining, including during bowel movements.
  • Pelvic pain: Pain or general discomfort in the pelvic region.

How is MRI Defecography Performed?

The MRI Defecography procedure begins with the patient lying on a moveable examination table that can slide into the MRI machine. Before the MRI scan begins, your healthcare provider might ask you to change into a hospital gown, and a chalky barium paste is usually introduced into the rectum. This substance helps to enhance the detail of MRI images produced during the test. To highlight the vaginal wall between the rectum and vagina in female patients, barium paste may also be applied inside the vagina.

As the test progresses, the patient may be required to simulate a bowel movement. This allows the MRI machine to capture the function of the pelvic floor muscles and create detailed images of the anorectal junction.

These images can be important in diagnosing and determining a treatment course for certain structural abnormalities, pelvic organ prolapse, pelvic floor disorders and other issues that can impact the function of the lower GI tract.

What is the “Pelvic Floor”?

The pelvic floor is a complex structure in the pelvis composed of layers of muscle and connective tissue that stretch like a hammock from the pubic bone in the front of the body to the tailbone at the back. This network of muscles, ligaments and tissues provides support for the organs of the pelvis, including the bladder, the rectum, the uterus in women and the prostate in men.

The pelvic floor plays an important role in several bodily functions, including helping control the release of urine and feces and facilitating sexual function. A strong and healthy pelvic floor can help prevent pelvic organ prolapse, a condition in which the pelvic organs descend due to weakened support, as well as pelvic pain and pelvic floor dysfunction, which can make it hard to relax the pelvic muscles during bowel movements.

How is MRI Defecography Different From Other Tests That Can Diagnose the Same Conditions?

MRI Defecography offers several advantages:

  • The defecography MRI exam provides detailed images of the pelvic region
  • MRI defecography can capture the structures of the pelvis and pelvic floor in action, unlike static imaging tests.
  • Magnetic resonance imaging (MRI) technology utilizes a magnetic field to create images and involves no radiation, making it safer than X-rays for certain patients.
  • MR defecography can usually visualize soft tissues, muscles and internal organs better than other imaging tests.

Are There Any Potential Side Effects or Complications of MRI Defecography?

While MRI Defecography is generally considered very safe, some patients might experience:

  • Mild bloating due to the contrast material
  • Discomfort during the insertion of contrast into the rectum
  • Allergic reactions to the contrast agent, though these are very rare
  • The potential for discomfort for patients who have claustrophobia, as utilizing an MRI machine usually involves being placed in a tunnel that passes through the machine. Claustrophobic patients may be able to utilize an open MRI unit, which is much less closed-in and restrictive than a traditional MRI machine. 

As a Patient, What Do I Need To Do To Prepare For MRI Defecography?

Always follow the instructions given to you by your healthcare provider. However, preparation for MRI defecography usually involves:

  • Informing your physician or radiologist about any medical devices or metallic objects in the body, including metal pins or screws from previous surgeries or medical devices like pacemakers
  • Discussing your medical history with the healthcare provider, including any allergies you might have
  • Telling your healthcare provider about any medications you may be taking, including over-the-counter drugs, prescription medications and supplements.
  • Fasting may be required before the test.
  • Wearing clothes without metal zippers or buttons, as these can interact with the magnetic field produced by the MRI machine. You may also be asked to disrobe and wear a hospital gown, so wearing loose fitting clothing to the appointment is usually recommended.

Patients Ask, Hoag Answers

FAQs about MRI Defecography.

Is MRI Defecography painful?

The procedure itself is not painful. However, some discomfort might be felt during the insertion of the contrast material into the rectum. The sensation is similar to having a bowel movement.

Is MRI defecography safe for every patient?

MRI defecography is safe for most patients. However, those with metal implants, implanted medical devices or other metallic objects in their body should inform their healthcare provider, as the magnetic field generated during MRI exams can interact with metal objects.

Also, those with severe claustrophobia should tell their doctor, as MRI exams usually involve being slid into a round tube inside the MRI machine, which may feel restrictive. Some newer MRI machines feature larger openings, or patients may be able to utilize an open MRI unit, which is much less restrictive.

Does MRI defecography involve radiation?

MRI defecography utilizes magnetic resonance imaging, which uses magnetic fields to create detailed images of the pelvic organs. The MRI machine does not produce ionizing radiation, and an MRI exam generally does not involve radioactive substances like radioactive contrast agents. This makes MR defecography safer than some other imaging tests, particularly for patients who are pregnant or might be pregnant, or those who need multiple imaging scans.

How long does MRI defecography take to complete?

For most patients, the process usually lasts between 30 minutes to an hour, which includes the time taken to introduce the contrast material into the rectum, place the patient in the correct position inside the MRI machine and capture the images. Additionally, patients might be asked to simulate bowel movements during the exam, which can slightly increase the amount of time required to complete the test.

When can I expect to receive the results of my MRI defecography exam?

After the test, the images collected during the test will be analyzed by a radiologist. The results are then sent to the referring physician, who will discuss the findings with the patient. Typically, patients can expect to receive their results within a few days to a week.

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