MRI Defecography

MR Defecography (also known as MRI of the pelvic floor, rectum and sphincter) is a magnetic resonance imaging exam that doctors use to look at problems in the structure of the pelvic floor or problems with how these muscles are working when you move your bowels.

MRI does not use radiation like X-rays and other imaging techniques do. Instead, MRI uses radio waves and a strong magnetic field to create sharp pictures. Even different types of tissue in the same organ can be easily seen with MRI.

We will ask you to purchase a mild enema kit from your local pharmacy to take the day before your exam. You may eat, drink, and take your medications as normal.

Tell the MRI staff if you have:

• Aneurysm clips, a heart pacemaker (or artificial heart valve), an implanted port, an infusion catheter, an intrauterine device (IUD), any metal plates, clips, pins, screws, or surgical staples, a prosthetic hip, or any implanted metal object in your body
• Tattoos or permanent eyeliner
• Medicine patches
• A bullet or shrapnel in your body
• Ever worked with metal
• Had any surgeries

For women:

• Tell staff if you are or may be pregnant.
• Most of the time, surgical staples, clips, plates, pins, and screws are not a risk during an MRI exam if they have been in place for more than 4 to 6 weeks. If there is any question about metal fragments in your body, we may do an X-ray to check for them.
• Remove any items that might affect MRI pictures. These include hairpins, jewelry, glasses, hearing aids, and any removable dental work.

Before Your Exam

• You will need to take a mild enema the day before your exam.
• You will need to hold urine in your bladder for 30 minutes before your exam.
• The technologist will talk with you about the scan and answer your questions.

You will lie on your back on a sliding table.

Females:

• The technologist will insert a catheter (thin, plastic tube) into your rectum and vagina, and then inject about 200 mL (less than 1 cup) of gel through the catheter into your rectum and about 30 mL (1 oz) into your vagina. The gel will put pressure on your body parts in that area, and that will make different tissues show up better on the MRI.
• The technologist will then remove the catheter from your rectum.
• You may feel some pain or discomfort when the catheters are inserted into your vagina and rectum. Tell the technologist if you are having discomfort.

Males:

• The technologist will insert a catheter (thin, plastic tube) into your rectum then inject about 200 mL (less than 1 cup) of gel through the catheter into your rectum. The gel will put pressure on your body parts in that area, and that will make different tissues show up better on the MRI.
• The technologist will then remove the catheter from your rectum.
• You may feel some pain or discomfort during the insertion in your rectum. Tell your doctor if you are having discomfort.

MR Defecography lasts about 30 minutes. Some patients feel a small amount of discomfort from bloating or cramping during the exam. Please arrive at the clinic 15 minutes before your scheduled exam. You will change into a hospital gown and put on an adult diaper. This is so you can move your bowels while the MRI takes pictures of the muscles in your pelvic floor.

A set of MRI signal detectors called imaging coils, will be placed on your pelvic area. The imaging coil receives the signal from the magnet and sends the signal to the computer to produce the images of your pelvic floor.

After positioning you in the MRI scanner, the technologist will move to the scanner control room that is right next to the room you will be in. The technologist will be able to see you and hear you at all times. You will also be given a call button in case you need to speak with the staff at anytime during the exam.

When the exam begins, the MRI scanner will make repeated knocking sounds as it is taking the pictures of your pelvis. You will be given earplugs or headphones to lessen the sound.

During the exam, the technologist will ask you to “bear down”, “relax”, or “hold in”. You will also be asked to defecate into the diaper so that a radiologist can observe how your rectum empties.

• MRI is not painful.
• MRI is done in an enclosed unit. Some patients may feel claustrophobic. Please tell the doctor who referred you for the MRI if you are claustrophobic. Your doctor may give you medicine that will help you relax during your exam. Our Open bore MRI has an opening of 70cm (more than 2 feet) instead of the standard 60cm. The head-in, feet-out design, the bigger opening and the shorter length (125cm instead of 250cm) will help reduce the feeling of claustrophobia.
• You may notice a warm feeling in the area where the pictures are taken. This is normal. If it bothers you, please tell the technologist.
• You will hear loud tapping or knocking noises during the scan. We will provide earplugs or music to listen to through headphones to block some of these sounds.

After the exam is complete, the staff will bring you to a private restroom and you will be given a washcloth and towel to wash up.

No. There are no risks associated with MR Defecography. Some patients feel mild bloating or cramping from the air that enters the rectum when the gel is inserted. This feeling will lessen each time you pass gas. Most patients can return to normal activities after the exam.

MRI allows the complete study of pelvic components. Unlike conventional Defecography no opacification of the small intestine is required, therefore no swallowed product is taken (Barium).The duration of the exam is shorter and the analysis more complete.

A radiologist skilled in MR Defecography will review and interpret your MRI images. The radiologist, technologist and other staff may not discuss the results with you, but will send a report to your referring doctor. This doctor will give you the results.