We evaluated the clinical usefulness of 2D- and 3D-MR proctography using a ultrafast MR technique for assessing the fecal continence in children after treatment for anorectal anomalies.1O children after treatment for anorectal anomalies were included in this study. A turbo-FLASH and a 3D-FISP sequences were used to acquire 2D-and 3D-MR images, respectively. After injecting of OMR-2200, MRproctogram was started with the patient at rest, during squeezing, and during expulsion or at maximum straining. From 2D-cine MR images, the temporal changes of the anorectal angle, the width of the anal canal, the movement of the levator sling were measured. From 3D-volume images, volumetric analysis were performed in each phase.
On 2D-cine images, wide anorectal angle and dilatation of the anal canal at rest and during straining, and poor movement of the levator sling were noted in children with fecal incontinence. In these children, volumetric analysis showed no significant difference was present between squeezing and straining. Among 8 children on whom conservative treatment was performed, follow-up MR proctograhy showed therapeutic effects in 2 children.
It was our conclusion that 2D- and 3D-MR proctography provides detailed, physiologic information about the conditions of anorectal canal in children after treatment for anorectal anomalies.