Imaging of anorectal disease

Background: Over the past two decades developments in imaging have changed the assessment of patients with anorectal disease. Methods: The literature on imaging techniques for anorectal diseases was re viewed over the period 1980-1999. Results: For the staging of primary rectal tumours, phased array magnetic r esonance imaging (MRI) may be regarded as the most appropriate single techn ique. The combination of endosonography or endoluminal MRI with ultrasonogr aphy or spiral computed tomography yields similar results. All techniques h ave limitations both for local staging and in the assessment of distant met astases. MRI or positron emission tomography is preferable for tumour recur rence. For perianal fistula, high-resolution MRI (phased array or endolumin al) is the technique of choice. For constipation, defaecography is the pref erred technique, nowadays with emphasis on functional information. The role of magnetic resonance defaecography is currently being evaluated. For faec al incontinence, endosonography and endoluminal MRI give similar results in detecting sphincter defects; endoluminal MRI has the advantage of detectin g external sphincter atrophy. Conclusion: High-resolution MRI, endosonography and defaecography are curre ntly the optimal imaging techniques for anorectal disease.