ArticleAbdominal radiology (New York)2026
The diagnostic value of magnetic resonance defecography in differentiating evacuation disorders among patients with manometric dyssynergia.
Article in Abdominal radiology (New York), 2026. 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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Who cites it
2 citing papers in PubMed.
- Paeoniflorin adjunct to scar release surgery for postoperative anorectal stenosis: a randomized controlled trial.Frontiers in surgery · 2026Trial
- Diagnostic performance of three-dimensional high-resolution anorectal manometry in identifying descending perineal syndrome.Frontiers in medicine · 2026Article
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Authors and funding
8 authors.
Funding
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Abstract
purposeThis study aimed to evaluate patients exhibiting a dyssynergic pattern on anorectal manometry (ARM) using Magnetic Resonance Defecography (MRD) to distinguish "true" Dyssynergic Defecation (DD) from structural Non-Dyssynergic Evacuation Disorders (NDED) and to identify the most reliable radiological diagnostic criteria. MATERIALS AND
methodsThis retrospective cross-sectional study included 252 patients who exhibited a dyssynergic pattern on ARM. Patients were re-evaluated using MRD and classified into two groups: those confirmed as DD and those reclassified as NDED. The prevalence of structural abnormalities (rectocele, cystocele, descent of the anorectal Junction [DAJ]) and the diagnostic accuracy of MRD parameters (incomplete evacuation, paradoxical sphincter contraction with abnormal anorectal angle [ARA] changes, absence of perineal descent) were analyzed.
resultsOf the 252 patients diagnosed with dyssynergia by ARM, only 142 (56.3%) were confirmed as DD by MRD, while 110 (43.7%) were diagnosed with NDED. DD was significantly more prevalent in males (69.2%, p = 0.006), whereas structural pathologies were predominant in the NDED group. The presence of cystocele, rectocele, and DAJ significantly reduced the likelihood of a DD diagnosis (p < 0.001). Among diagnostic criteria, the combination of "paradoxical sphincter contraction with abnormal ARA" demonstrated the highest diagnostic validity (Sensitivity: 97.1%, Specificity: 99.1%, Accuracy: 98%). In contrast, incomplete evacuation alone showed high sensitivity (94.3%) but low specificity (45.4%).
conclusionARM alone is insufficient for diagnosis due to high false-positive rates, particularly in patients with structural abnormalities. MRD plays a crucial complementary role in identifying 'true' DD and accurately distinguishing it from structural evacuation disorders. This integrated approach prevents unnecessary biofeedback therapy for patients requiring structural correction.
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