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  • Magnetic resonance imaging  (1,657)
  • Springer  (1,657)
  • Blackwell Science Ltd
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  • 1
    Electronic Resource
    Electronic Resource
    Diffuse cavernous hemangioma of the rectum complicated by invasion of pelvic structures (1998)
    Springer
    Diseases of the colon & rectum 41 (1998), S. 1062-1066 
    Details
    ISSN: 1530-0358
    Keywords: Colonic neoplasms, complication ; Hemangioma, cavernous ; Magnetic resonance imaging ; Tomography, x-ray computed
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: We present two cases of diffuse cavernous hemangioma of the rectum that invaded the pelvic structures. METHODS: Two young women suffering from intermittent rectal bleeding were studied using computed tomography and magnetic resonance imaging. RESULTS: Beside the rectal hemangioma, computed tomography and magnetic resonance imaging revealed that the pelvic ureter and the iliac vessels were each eroded by the tumor that produced symptoms in these two patients. CONCLUSION: Computed tomography and magnetic resonance imaging permit direct visualization for tumor staging and also for recognition of any pelvic structure invasion, which facilitate preoperative assessment of diffuse cavernous hemangioma of the rectum.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02237403
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  • 2
    Electronic Resource
    Electronic Resource
    Use of vector volume manometry and endoanal magnetic resonance imaging in the adult female for assessment of anal sphincter dysfunction (1999)
    Springer
    Diseases of the colon & rectum 42 (1999), S. 1411-1418 
    Details
    ISSN: 1530-0358
    Keywords: Endoanal ; Magnetic resonance imaging ; Vector volume ; Manometry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: This study compared conventional water-perfused and vector volume anal manometry in female patients with neurogenic fecal incontinence and chronic anal fissure and in healthy female volunteers. We used endoanal magnetic resonance (MR) imaging to measure internal and external sphincter lengths and thicknesses and contrasted these with the manometric findings in the different anorectal conditions. METHODS: One hundred thirty-three female subjects were studied over an eight-month period, including 33 control volunteers, 83 patients with neurogenic fecal incontinence, and 17 patients with chronic anal fissure. Conventional manometry was contrasted with automated vector volume-derived parameters. Endoanal magnetic resonance images were obtained using a previously described internal coil with a 0.5 T Asset™ scanner measuring quadrantal internal sphincter thickness and averaged coronal internal and external sphincter lengths. RESULTS: There was a statistically significant relationship between parameters measured by conventional manometry and those variables derived from vector volume manometry at rest and squeeze. There was no difference in sectorial vector-derived pressures within any anorectal condition and no correlation between quadrantal internal sphincter thickness measurements and sectorial pressures at rest. Patients with chronic anal fissure and neurogenic fecal incontinence had constitutionally shorter superficial and subcutaneous external sphincters than healthy control subjects (P〈0.001). CONCLUSIONS: There is no association between manometric findings and morphologic sphincter measurement; however, the shorter distal external sphincter in patients with fissure might render the lower anal canal relatively unsupported after internal sphincterotomy in the female patient.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02235038
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  • 3
    Electronic Resource
    Electronic Resource
    Association of anterior ectopic anus and partial absence of levator musculature in a woman with impaired defecation (1990)
    Springer
    Diseases of the colon & rectum 33 (1990), S. 974-976 
    Details
    ISSN: 1530-0358
    Keywords: Constipation ; Defecography ; Magnetic resonance imaging ; Anterior ectopic anus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 25-year-old nulliparous woman with adult onset constipation and slight anterior displacement of the anus underwent pelvic magnetic resonance imaging and was diagnosed with congenital hemiabsence of the levator ani sling. Impaired defecation was confirmed by anorectal function studies and defecography demonstrated an anterior rectocele, perineal descent at the upper limit of normal, and partial obstruction of defecation, which appeared related to the levator sling abnormality. To our knowledge, this combination of findings has not been previously described as a cause of adult onset constipation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02139109
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  • 4
    Electronic Resource
    Electronic Resource
    Preoperative staging of rectal cancer by endoluminal ultrasoundvs. magnetic resonance imaging (1994)
    Springer
    Diseases of the colon & rectum 37 (1994), S. 1189-1193 
    Details
    ISSN: 1530-0358
    Keywords: Rectal cancer ; Preoperative staging ; Endoluminal ultrasound ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: The aim of this study was to compare the value of endoluminal ultrasonography (ELUS) with magnetic resonance imaging (MRI) for preoperative staging of rectal carcinoma. METHODS: Thirty-seven consecutive patients were examined by ELUS and MRI. Imaging results were compared with pathohistologic studies. A tumor extending beyond the bowel wall was considered to be “positive” and one within the bowel wall was considered “negative.” Lymph node involvement was considered present if nodes equal to or greater than 5 mm in diameter were found in the perirectal tissue. For evaluating the differences between the two methods, the Mc Nemar test was performed. RESULTS: T-Staging was correct in 88.2 percent (30/34) of patients by ELUS and in 82.3 percent (28/34) by MRI (difference not significant). N-Staging was correct in 80 percent (20/25) by ELUS and in 60 percent (15/25) by MRI (difference of borderline significance). A comprehensive preoperative staging (T + N) was made correctly in 68 percent (17/25) by ELUS and in 48 percent only (12/25) by MRI (difference not significant). CONCLUSIONS: We suggest that ELUS and MRI must be evaluated within the framework of established parameters when treatment modalities such as preoperative radiation therapy and local or radical surgical approach must be decided.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02257780
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  • 5
    Electronic Resource
    Electronic Resource
    Anterior rectocele: Assessment with radiographic defecography, dynamic magnetic resonance imaging, and physical examination (1994)
    Springer
    Diseases of the colon & rectum 37 (1994), S. 249-259 
    Details
    ISSN: 1530-0358
    Keywords: Anterior rectocele ; Defecography ; Magnetic resonance imaging ; Clinical assessment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: The aim of this study was to devise a measuring method for an anterior rectocele on standardized defecographies and magnetic resonance images (MRI) to quantify anterior rectocele and to test whether this could substantiate clinical decision making for operative treatment for anterior rectocele. METHODS: Quantitative analysis by the measuring method as proposed was compared with qualitative scores on defecographies and MRI from the same patients. Thirty-eight patients with symptoms compatible with an anterior rectocele were subjected to physical examination in the left decubitis position and supine position and to defecography. Findings on defecography were compared with findings on physical examination. Thirteen patients were examined before and after surgical correction of the anterior rectocele for a total of 51 qualitative and quantitative examinations. The group of operated patients was analyzed for treatment results. Nineteen controls were included. RESULTS: Sixtysix radiographs of 33 defecographies were qualified in three grading classes and quantified with the proposed method by two observers. The mean measured value of the anterior rectocele in the three subjective grading classes is significantly different (P 〈 0.001). Anterior rectoceles qualified as severe had a measured value of 20 mm or more in 96 percent of the radiographs. Lower gradings were never 〉20 mm. On MRI severe anterior rectoceles were not scored and measured values did not correlate with qualitative scores. When findings on physical examination were compared with defecographic measurement, the coefficient of correlation (r)between the radiologic assessment and clinical examination in the left decubitis position is r = 0.87, for the examination in the supine position,r = 0.77. All 15 cases scored as severe anterior rectocele in the left decubitis position had a measured anterior rectocele of ≥20 mm. In the 13 cases that received surgery, there was a significant reduction of the anterior rectocele (P 〈 0.001) and clinical improvement. Patients with small or moderate anterior rectocele on physical examination with a size ≥20 mm on defecography were cured by surgical correction. None of the controls had an anterior rectocele on physical examination or an anterior rectocele ≥20 mm on defecography. CONCLUSIONS: An anterior rectocele with a size of 20 mm or more corresponds with a qualitative score of “severe” on Radiographic defecography. Physical examination for anterior rectocele in the left decubitis position corresponds best with quantitative Radiographic assessment and anterior rectocele with a size ≥20 mm on defecography is pathologic. Patients with complaints compatible with anterior rectocele can be assessed in objective and quantitative terms by radiography and can be successfully surgically treated, even if at physical examination the anterior rectocele is not classified as large, provided that dynamic defecography shows an anterior rectocele of ≥20 mm. The potential of dynamic MRI with regard to anterior rectoceles presently seems absent.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02048163
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  • 6
    Electronic Resource
    Electronic Resource
    Magnetic resonance imaging of fistula-in-ano (1994)
    Springer
    Diseases of the colon & rectum 37 (1994), S. 708-718 
    Details
    ISSN: 1530-0358
    Keywords: Magnetic resonance imaging ; Fistula-in-ano
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Successful management of anal fistulas depends upon accurate assessment of the primary tract and any secondary extensions. Preoperative imaging has, to date, been disappointing. METHODS: A prospective study of 35 patients with a clinical diagnosis of fistula-in-ano was performed comparing magnetic resonance imaging with the independently documented operative findings. Magnetic resonance imaging was also compared with anal endosonography in 20 patients. RESULTS: Magnetic resonance imaging is accurate and demonstrates pathology missed at surgery by experienced coloproctologists. Magnetic resonance imaging is superior to anal endosonography. CONCLUSIONS: Magnetic resonance imaging is advocated as the method of choice when imaging is required for anal fistulas.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02054416
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  • 7
    Electronic Resource
    Electronic Resource
    High resolution magnetic resonance imaging of the anal sphincter using a dedicated endoanal coil (1996)
    Springer
    Diseases of the colon & rectum 39 (1996), S. 926-934 
    Details
    ISSN: 1530-0358
    Keywords: Anal sphincter ; Endoanal coil ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: To obtain high resolution images of the anal sphincter and adjacent anorectum using an endoanal coil in patients with sepsis, trauma, and low rectal tumors and to compare imaging appearances with findings at time of surgery. PATIENTS AND METHODS: A cylindrical saddle geometry coil (diameter, 9 mm; length, 75 mm) was used to examine 30 patients (mean age, 53.6 years). Pathologies included perianal sepsis (10 patients), obstetric trauma (7 patients), and low rectal tumors (13 patients). Imaging was performed on an 0.5-T Picker Asset or 1.0-T Picker HPQ Vista (Picker International, Highland Heights, OH). T 1 and T 2 weighted and short inversion time inversion recovery transverse images and T 1 weighted coronal images were obtained. Intravenous gadopentetate dimeglumine (0.1 mmol/kg) was given to all patients with suspected infection and neoplasms. RESULTS: Abscesses and fistulas identified using magnetic resonance imaging (MRI) in patients with perianal sepsis were confirmed at surgery in all cases; site of fistulous internal opening into the anal canal was correctly identified in 80 percent of cases. Extent of sphincter tear was correctly assessed on endoanal MRI in all patients with obstetric trauma when compared with surgical findings. Tumor invasion of anal sphincter was seen in 38.5 percent of low rectal carcinomas. CONCLUSIONS: MRI with an endoanal coil provides detailed images of the site and extent of anal fistulas, sphincter tears, and local tumors and is of considerable value in preoperative assessment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02053993
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  • 8
    Electronic Resource
    Electronic Resource
    Preoperative staging of irradiated rectal cancers using digital rectal examination, computed tomography, endorectal ultrasound, and magnetic resonance imaging does not accurately predict T0,N0 pathology (1997)
    Springer
    Diseases of the colon & rectum 40 (1997), S. 140-144 
    Details
    ISSN: 1530-0358
    Keywords: Rectal cancer ; Computed tomography ; Radiotherapy ; Endorectal ultrasound ; Staging ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: The postradiation preoperative staging results of 25 patients with rectal cancer who were found to have Stage T0,N0 lesions after surgery were examined. Our aim was to assess the ability of preoperative staging following radiation therapy to predict the absence of disease. METHODS: From 1983 to 1994, 25 patients treated with preoperative radiation therapy for biopsy-proven rectal cancer were found to have no pathologic evidence of disease in the resected specimen (T0,N0). The preoperative postradiation disease staging results of these patients were compared with the postoperative pathologic findings. Each patient received 4,500 to 5,580 cGy during a five-week to six-week period, and four patients had preoperative chemotherapy. Surgical resection was performed six to eight weeks after completion of radiation therapy. All 25 patients were staged by digital rectal examination before surgery. In addition, 13 patients were assessed using computed tomography, 6 by endorectal ultrasound, and 1 by magnetic resonance imaging. RESULTS: Most irradiated lesions were overstaged by radiologic assessment and physical examination. No technique could reliably distinguish between postradiation fibrosis and residual cancer. The negative predictive value for digital rectal examination was 24 percent. Computed tomography accurately staged 23 percent of lesions, and endorectal ultrasound predicted 17 percent of lesions correctly. The single patient evaluated by magnetic resonance imaging was overstaged and thought to have a T2 lesion. CONCLUSIONS: Our ability to assess local eradication of rectal cancer following radiation therapy remains poor. Conventional imaging and clinical examination techniques are unable to safely predict which patients do not require surgical excision following curative radiation therapy for rectal cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02054977
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  • 9
    Electronic Resource
    Electronic Resource
    Anatomy of the anal sphincters (1994)
    Springer
    Diseases of the colon & rectum 37 (1994), S. 777-781 
    Details
    ISSN: 1530-0358
    Keywords: Anal ultrasound ; Magnetic resonance imaging ; Internal anal sphincter ; External anal sphincter
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: A recent application of endosonography in the evaluation of anal sphincter morphology has led to controversy about the possibility of precisely assessing the diameter of external and internal anal sphincter muscles. On the other hand, magnetic resonance imaging (MRI) has been proposed to allow a more detailed view of the anatomy of the pelvic floor. However, both techniques have not yet been compared directly. METHODS: Eight healthy volunteers (age range, 25–40 years; 5∶3, male∶female) participated. Anal ultrasound was performed using a 7.5-MHz rectal transducer which produced a transversal panorama display of 360, allowing an image perpendicular to the anal canal. Imaging of the diameter of the internal and external anal sphincter muscles was performed with the transducer placed in the midanal canal, and measurement was always performed by the same investigator in dorsal projection. MRI was performed using a 1.5 Tesla Magnetom (Siemens, Erlangen, Germany) to obtain sagittal and angled axial (perpendicular to the anal canal) planes for consecutive 3-mm slices which were evaluated by four independent raters. RESULTS: Muscle thickness of the sphincter muscles in dorsal projection was 1.96±0.61 mm for the internal sphincter and 6.35±1.07 mm for the external sphincter using ultrasound. It was 1.72±0.13 mm and 3.99±0.99 mm, respectively, using MRI. When both measures were compared, only the internal sphincter data correlated significantly (r=0.818,P=0.0023) between both measures. Sagittal resonance imaging of the anal canal did not allow for differentiation of both muscles at all. Differentiation among mucosa, submucosa, and internal anal sphincter is not possible with MRI but may well be performed with high-resolution ultrasound. CONCLUSION: Anal ultrasound carries the potential of becoming a routine clinical procedure for evaluation of the anal anatomy and morphology in defecation disorders, but current MRI assessment of the anal anatomy is elaborate, costly, and does not provide any further insights.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02050142
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  • 10
    Electronic Resource
    Electronic Resource
    Large aggressive angiomyxoma of the perineum and pelvis: An alternative approach (1998)
    Springer
    Diseases of the colon & rectum 41 (1998), S. 514-516 
    Details
    ISSN: 1530-0358
    Keywords: Angiomyxoma ; Intraoperative radiation therapy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Aggressive angiomyxomas are rare soft tissue tumors found mainly in the female reproductive mesenchyme and pelvis. They are low-grade sarcomas that have a propensity to recur locally. These tumors are encapsulated and have the same consistency as normal connective tissue, thus making wide excision difficult. We report a case of a large aggressive angiomyxoma in the perirectal tissues treated with preoperative angiographic embolization, causing ischemia of the tumor and, thus, improved visualization of the lesion. In addition, preoperative external beam irradiation and intraoperative electron beam radiotherapy were used to decrease the chances of local recurrence.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02235768
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