Evidence map›Paper›PMID 37542178›Full record

ArticleAbdominal radiology (New York)2023

Diagnostic performance of dynamic MR defecography in assessment of dyssynergic defecation.

Pimpapon Thanaracthanon, Kewalee Sasiwimonphan, Angkana Sunthornram, Mukesh G Harisinghani, Thitinan Chulroek

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Article in Abdominal radiology (New York), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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3 · Its place in the literature

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2 citing papers in PubMed.

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5 · Who and what money

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5 authors.

Pimpapon ThanaracthanonDepartment of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Kewalee SasiwimonphanDepartment of Radiology, King Chulalongkorn Memorial Hospital, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, Thailand.ORCID 0000-0001-7501-3795
Angkana SunthornramDepartment of Radiology, King Chulalongkorn Memorial Hospital, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, Thailand.
Mukesh G HarisinghaniDepartment of Radiology, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA, 02114, USA.ORCID 0000-0003-0993-1947
Thitinan ChulroekDepartment of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. thitinan.c@chula.ac.th.ORCID 0000-0002-3651-3110

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo assess diagnostic performance of MR defecographic findings in diagnosis of dyssynergic defecation (DD).

methodsThis retrospective study included 46 patients with chronic constipation who met the Rome IV criteria for diagnosis of present or absent DD and underwent MRI between Jan 2015 and June 2020. Patients were divided into DD group (n = 24) and non-DD group (n = 22). Nine parameters were analyzed by two radiologists: anorectal angle (ARA) and M line at rest, defecation, and change between 2 phases; anal canal width; prominent puborectalis muscle; abnormal evacuation. Receiver operating characteristic (ROC) curves were plotted to extract the optimal cut-offs and area under the curve (AUC). Multivariate analysis was performed.

resultsSeven findings showed statistically significant difference between DD and non-DD groups. M line at defecation had highest odds ratio, followed by ARA change, ARA at defecation, M line change, prominent puborectalis muscle, abnormal evacuation and anal canal width, respectively. ARA change and prominent puborectalis muscle had highest specificity (95.5% and 100%, respectively). The optimal cut-offs of ARA at defecation, ARA change, M line at defecation, M line change and anal canal width were 122°, 1.5°, 3.25 cm, 1.9 cm and 8.5 mm, respectively. Multivariate logistic regression revealed two significant findings in differentiating between DD and non-DD, including M line at defecation (OR 23.31, 95% CI 3.10-175.32) and ARA at defecation (OR 13.63, 95% CI 1.94-95.53) with sensitivity, specificity, PPV, NPV and AUC of 79.2%, 95.5%, 95%, 80.8% and 0.87(95% CI 0.78-0.97), respectively.

conclusionMR defecography has high diagnostic performance in diagnosis of DD. Although M line and ARA at defecation are two significant findings on multivariate analysis, ARA change less than 1.5 degrees and prominent puborectalis muscle have good specificity in DD diagnosis.

Indexed as

AtaxiaConstipationDefecationDefecographyMagnetic Resonance ImagingAdultAgedAnal CanalFemaleHumansMaleMiddle AgedRetrospective StudiesSensitivity and SpecificityAnismusConstipationDyssynergic defecationMR defecography

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.