Dynamic Magnetic Resonance Imaging and Nuclear Imaging

Adil E. Bharucha, Joel G. Fletcher, and John H. Pemberton

Defecation requires intraabdominal pressure coordinated with relaxation of the anal sphincters and pelvic floor muscles, particularly the puborectalis muscles. Pelvic floor motion can be imaged in real-time by barium fluoroscopy, radioisotope scintigraphy, or magnetic resonance imaging (MRI). Barium evacuation proc-tography was described in separate reports by Burhenne1 in 1964 and Phillips and Edwards2 in 1965. O'Connell et al3 developed scintigraphy to quantify rectal evacuation after ileal pouch anal anastomosis with lesser radiation exposure compared to barium proctography. Dynamic MRI visualizes anorectal and pelvic floor motion during rectal evacuation without radiation exposure.4

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