Celine Desiree Alt MD, Presenter: Nothing to Disclose

Cornelia Putz, Abstract Co-Author: Nothing to Disclose

Cornelia Hensel, Abstract Co-Author: Nothing to Disclose

Bjoern Wagner, Abstract Co-Author: Nothing to Disclose

Norbert Wagner, Abstract Co-Author: Nothing to Disclose

Hans-Juergen Gerner, Abstract Co-Author: Nothing to Disclose

Hans-Ulrich Kauczor MD, Abstract Co-Author: Research Grant, Boehringer Ingelheim GmbH Research Grant, Siemens AG Speakers Bureau, Boehringer Ingelheim GmbH Speakers Bureau, Bayer AG Speakers Bureau, Siemens AG

Lars Grenacher MD, Abstract Co-Author: Nothing to Disclose

Neurogenic bowel dysfunction represents a common clinical problem in spinal cord medicine, which severely affects the quality of life following spinal cord injury (SCI). The aim of this study was to evaluate functional MRI as a diagnostic tool to visualize neurogenic bowel dysfunction in SCI patients.

In this prospective study, 20 Th1-10 SCI patients (AIS A) given written informed consent and the study proposal was approved by the local ethics committee. Examination was performed at a 3T scanner in lateral position with angled legs. The rectum was filled with ultrasonic gel. The protocol included T2w truFISP sequences in tree planes at rest and in sagittal plane during defecation (30 measurements) and T2w turbo spin echo images in sagittal and axial plane. Evaluation included the hiatal width (H-line), the M-line, the anorectal angle (ARA) and the anorectal junction (ARJ). The rectal filling volume and the maximum rectum diameter were noted, until defecation procedure started.

11 SCI patients had a spastic anal sphincter tone. The median rectal volume was 215 ml, the maximum rectum diameter was 4.7 cm. On average, 17 measurements were necessary until defecation started. The median changes of H-line, M-line, ARA and ARJ was 0.3 cm, 1.7 cm, 10.1°, and 2.0 cm respectively. 9 SCI patients had a flaccid sphincter tone. The median rectal volume was 194 ml, the maximum rectum diameter was 5.1 cm. On average, 11 measurements were necessary until defecation started. The median changes of H-line, M-line, ARA and ARJ was 0.7 cm, 1.4 cm, 10.6°, and 1.1 cm respectively.

MR-Defecography is feasible in SCI patients and may help to differentiate between different types of neurogenic bowel dysfunction.

Dynamic MRI may serve as a diagnostic tool to guide therapeutic decision making in SCI patients suffering from neurogenic bowel dysfunction.

Alt, C, Putz, C, Hensel, C, Wagner, B, Wagner, N, Gerner, H, Kauczor, H, Grenacher, L, Neurogenic Bowel Dysfunction in Spinal Cord Injury Patients - Diagnostic Using Functional MRI. A Feasibility Study.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13021591.html