Diagnosing enteroceles using dynamic magnetic resonance imaging

PURPOSE: Enteroceles are in part difficult to detect but a frequent finding in pelvic floor disorders. The aim of this study was to evaluate magnetic resonance colpocystorectography in the diagnosis of enteroceles. METHODS: I n this prospective study 11 volunteers and 55 patients with pelvic floor de scent were examined. In addition to magnetic resonance colpocystorectograph y, a dynamic cystoproctography was performed on 34 patients. Opacification of organs was used. An enterocele was assessed in relationship to the puboc occygeal reference line (magnetic resonance colpocystorectography) or the w idth of the rectovaginal space (dynamic cystoproctography). A clinical gyne cologic examination served as reference. RESULTS: The clinical examination diagnosed an enterocele in 43, magnetic resonance colpocystorectography in 49, and dynamic cystoproctography in 14 cases. Magnetic resonance colpocyst orectography further subdivided the enteroceles according to their contents (mesenteric fat or fluid, 12; small bowel, 32, large bowel, 3; and rectosi gmoidocele, 2). Magnetic resonance colpocystorectography proved statistical ly significantly superior to dynamic cystoproctography (15 cases) and the r eference. Sensitivity and specificity of magnetic resonance colpocystorecto graphy were 100 percent each. It was able to reveal clinically missed enter oceles as being peritoneoceles associated with a rectocele or a uterovagina l prolapse (10 cases). CONCLUSION: Magnetic resonance colpocystorectography is a promising method for diagnosis of enteroceles, because hernial canal, sac, and contents are reliably identified.