磁共振排粪造影诊断排便协同失调的标准
Magnetic Resonance Defecography Criteria for the Diagnosis of Dyssynergic Defecation.
摘要(中文译文)
关于磁共振排粪造影（MRD）在确认排便协同失调（DD）方面诊断价值的证据有限。本研究旨在评估MRD参数在识别DD患者中的诊断效能。本回顾性研究在一所大学医院开展，分析了2020年至2024年间235例连续成年慢性原发性便秘患者的数据，这些患者均接受了高分辨率肛门直肠测压（HR-ARM）、球囊排出试验和MRD检查。以HR-ARM联合球囊排出试验作为参考标准，评估各项动态MRD参数的诊断效能。共纳入109例受试者（女性86例；平均年龄53.1±15.3岁），其中70例（64.2%）被诊断为DD。定量动态MRD参数，包括M线、肛门直肠角（ARA）和肛管宽度（ACW），在区分DD患者方面表现出显著良好的判别能力（均P<0.05）。在排粪时M线为2.0 cm并结合耻骨直肠肌突出或排粪时对比剂排出异常、M线变化为1.6 cm、排粪时ARA为114°、ARA变化为-5°以及排粪时ACW为10 mm的截断值下，这些参数表现出可接受的诊断效能，达到了最佳的特异度（82.1%至92.3%）、阳性似然比（3.66至7.06）和诊断比值比（8.25至14.25）。多因素分析确定排粪时ARA和ACW为DD的独立诊断预测因素（P<0.05）。这些发现支持建立实用且可靠的基于磁共振排粪造影的排便协同失调患者诊断标准。
Abstract
: Evidence regarding the diagnostic value of MR defecography (MRD) for confirming dyssynergic defecation (DD) is limited. We aim to evaluate the diagnostic performance of MRD parameters in identifying patients with DD. : This retrospective study was conducted at a university hospital. Data from 235 consecutive adult patients with chronic primary constipation who underwent high-resolution anorectal manometry (HR-ARM), balloon expulsion test, and MRD between 2020 and 2024 were analyzed. The diagnostic performance of each dynamic MRD parameter was assessed using HR-ARM combined with balloon expulsion test as the reference standard. : A total of 109 participants (86 females; mean age 53.1 ± 15.3 years) were included, of whom 70 patients (64.2%) were diagnosed with DD. Quantitative dynamic MRD parameters, including the M-line, anorectal angle (ARA), and anal canal width (ACW), demonstrated significantly good discriminatory ability for differentiating patients with DD (all < 0.05). At cutoff values of 2.0 cm for the M-line at defecation combined with prominent puborectalis muscle or abnormal evacuation of contrast during defecation, 1.6 cm for M-line change, 114° for ARA at defecation, -5° for ARA change, and 10 mm for ACW during defecation, these parameters demonstrated acceptable diagnostic performance, achieving optimal specificities (82.1% to 92.3%), positive likelihood ratios (3.66 to 7.06), and diagnostic odds ratios (8.25 to 14.25). Multivariate analysis identified ARA and ACW at defecation as independent diagnostic predictors of DD ( < 0.05). : These findings support the establishment of practical and reliable MR defecography-based diagnostic criteria for patients with dyssynergic defecation.
如何引用
AMA
Suriya Keeratichananont, Kamonwon Cattapan, Jintaporn Heebpet, Siriporn Leelakiatpaiboon, Nisa Netinatsunton. Magnetic Resonance Defecography Criteria for the Diagnosis of Dyssynergic Defecation.. Journal of neurogastroenterology and motility. 2026; doi:10.5056/jnm26025.
APA
Suriya Keeratichananont, Kamonwon Cattapan, Jintaporn Heebpet, Siriporn Leelakiatpaiboon, Nisa Netinatsunton (2026). Magnetic Resonance Defecography Criteria for the Diagnosis of Dyssynergic Defecation.. Journal of neurogastroenterology and motility. https://doi.org/10.5056/jnm26025
GB/T 7714
Suriya Keeratichananont, Kamonwon Cattapan, Jintaporn Heebpet, Siriporn Leelakiatpaiboon, Nisa Netinatsunton. Magnetic Resonance Defecography Criteria for the Diagnosis of Dyssynergic Defecation.[J]. Journal of neurogastroenterology and motility, 2026 doi:10.5056/jnm26025.
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