Abstract
Sixteen postoperative patients with anorectal malformation were evaluated by MRI, and the results compared with the clinical assessment. Patients were classified into three groups — good (group 1,n=10), fair (group 2,n=3) and poor (group 3,n=3) — on the basis of Kelly's clinical score of incontinence. The degree of development of the puborectalis and external sphincter muscles and the levator hammock was evaluated on MRI in comparison with patients without anorectal disease. The proportions of fair or poor development of the muscles were 37% in group 1,22% in group 2 and 67% in group 3. Although fair or poor development of the muscles was seen more frequently in group 3, there was no statistically significant difference between groups. However, poorly developed muscles were seen only in patients with fair or poor clinical scores. The difference in the anorectal angle measured on sagittal MRI images between patients in group 1 and groups 2 or 3 was significant. Our study indicates that MRI evaluation based solely on muscle development can be misleading, and measurement of the anorectal angle should be included in the MRI evaluation.
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References
Stephens FD, Smith ED (1971) Ano-rectal malformations in children. Year Book, Chicago
Ong N, Beasley SW (1990) Comparison of clinical methods for assessment of continence after repair of high anorectal anomalies. Pediatr Surg Int 5: 233
Kiesewetter WB (1979) Rectum and anus. In: Ravitch MM, Welch KJ, Benson OD, Aberdeen E, Randolph JG (eds) Pediatric surgery, 3rd edn. Year Book, Chicago, p 1059
DeVries PA, Cox KL (1985) Surgery of anorectal anomalies. Surg Clin North Am 65: 1139
Pena A (1986) Posterior sagittal approach for the correction of anorectal malformations. In: Mannick JA, Cameron JL, Jordan GL Jr, et al (eds) Advances in surgery. Year Book, Chicago, p 69
Smith ED (1987) The bath water needs changing, but don't throw out the baby: an overview of anorectal anomalies. J Pediatr Surg 22: 335
Kohda F, Fujioka M, Ikawa H, Yokoyama J (1985) Congenital anorectal anomaly: CT evaluation. Radiology 157: 349
Taccone A, Martucciello G, Fondelli P, Dodero P, Ghiorzi M (1989) CT of anorectal malformation: a postoperative evaluation. Pediatr Radiol 19: 375
Arnbjornsson E, Laurin S, Mikaelsson C (1989) Computed tomography of anorectal anomalies: correlation between radiologic findings and clinical evaluation of faecal incontinence. Acta Radiol 30: 25
Mezzacappa PM, Price AP, Haller, JO, Kassner EG, Hansbrough F (1987) MR and CT demonstration of levator sling in congenital anorectal anomalies. J Comput Assist Tomogr 11: 273
Vade A, Reyes H, Wilbur A, Gyi B, Spigos D (1989) The anorectal sphincter after rectal pull-through surgery for anorectal anomalies: MRI evaluation. Pediatr Radiol 19: 179
Sato Y, Pringle KC, Bergman RA, Yuh WTC, Smith WL, Soper RT, Franken EA Jr (1988) Congenital anorectal anomalies: MR imaging. Radiology 168: 157
Scharli AF (1984) Analysis of anal incontinence. Prog Pediatr Surg 17: 93
Cywes S, Cremin BJ, Louw JH (1971) Assessment of continence after treatment for anorectal agenesis: a clinical and radiologic correlation. J Pediatr Surg 6: 132
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Fukuya, T., Honda, H., Kubota, M. et al. Postoperative MRI evaluation of anorectal malformations with clinical correlation. Pediatr Radiol 23, 583–586 (1993). https://doi.org/10.1007/BF02014969
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DOI: https://doi.org/10.1007/BF02014969