MRI combined with defecography on senile constipation caused by changes of levator plate and anal right An-gle

GAO Rong-qing; SHI Hai-rong; WANG Zhi-min

doi:10.19538/j.cjps.issn1005-2208.2024.06.17

Abstract：Objective To analyze the imaging mechanism of senile constipation caused by the changes of levator ani muscle plate and anus right angle by MRI combined with defecography.Methods 30 elderly constipation patients ad-mitted to The First Affiliated Hospital Of Shandong First Medical University from September 2019 to September 2022 were selected as the observation group,and 30 elderly healthy volunteers were recruited as the control group at the same time.In both groups,pelvic floor MRI and defecography were performed at rest and during forced ovulation to measure the decline of levator ani muscle plate(△ M-Line)and the change of anal right angle(△ ARA).Results(1)The length of M-Line and the angle of right angle of anus(ARA)in the observation group and the control group at rest were[(9.79±1.78)mm vs.(9.65±1.29)mm,P=0.741]and[(92.76±3.34)°vs.(93.91±5.48)°,P=0.335],respectively.There was no sig-nificant difference between the two groups(P＞0.05);the M-Line and ARA°of the observation group and the control group were[(14.81±1.74)mm vs.(13.79±1.42)mm,P=0.016]and[(103.07±4.84)°vs.(106.12±4.89)°,P=0.019]respec-tively under the force displacement state,with significant difference(P＜0.05);△M-Line and△ARA°were[(5.02±1.76)mm vs.(4.14±1.26)mm,P=0.029]and[(10.31±3.36)°vs.(12.21±2.91)°,P=0.021].There was significant difference be-tween the two groups(P＞0.05);(2)There was a positive correlation between the decline of levator ani muscle plate and Wexner's constipation quantitative score in the observation group under two conditions(correlation coeffi-cient r=0.852,P＜0.05);there was a negative correlation between the change of anal right angle(△ ARA°)and Wexner's constipation quantitative score(correlation coef-ficient r=-0.813,P＜0.05).Conclusion MRI combined with defectography can dynamically and static observe the decline of levator ANI muscle plate and the change of anal An-gle in patients with senile constipation,so as to provide a new basis for clinical accurate diagnosis and treatment of senile constipation.