Clinical value of pelvic 3-dimensional magnetic resonance image reconstruction in anorectal malformations

J Pediatr Surg. 2009 Dec;44(12):2369-74. doi: 10.1016/j.jpedsurg.2009.07.074.

Abstract

Objective: The study aimed to build a 3-dimensional (3D) reconstruction of pelvic magnetic resonance images and evaluate the clinical value in anorectal malformations (ARMs).

Methods: Magnetic resonance imaging (MRI) examinations were performed on a 1.5-T magnet. Sagittal, coronal, and transverse turbo spin-echo T1-weighted and fast spin-echo T2-weighted images of the pelvic region were obtained in 22 children. A 3D reconstruction was made on a computer and assisted by the 3D-Doctor software (Trial Version, Able Software Corp). The level and type of ARM and the developmental state of the striated muscle complex (SMC) were analyzed with 3D reconstruction image.

Results: The 3D images of the pelvic were confirmed in 22 cases. Three-dimensional reconstructed images perfectly displayed the anatomical relationships of the SMC and the rectal atresia in these spaces. The 3D configuration of the SMC was different in each of the high- and low-type cases. The high-type malformation of SMCs differed particularly from the descriptions.

Conclusions: Pelvic magnetic resonance 3D reconstructed images were able to show the dimensional anatomical relations of pelvis, bladder, urethra, rectum, and SMC. Both a 3D image and positional information with MRI offers the surgeon a simulated operative profile of the SMC superior to MRI slices alone, which will help in providing morphological data for image diagnosis and operation of the ARM.

Publication types

  • Comparative Study

MeSH terms

  • Anal Canal / abnormalities*
  • Anal Canal / pathology
  • Anal Canal / surgery
  • Child
  • Child, Preschool
  • Digestive System Abnormalities / pathology
  • Digestive System Abnormalities / surgery
  • Female
  • Humans
  • Image Processing, Computer-Assisted / methods*
  • Imaging, Three-Dimensional / methods
  • Infant
  • Infant, Newborn
  • Magnetic Resonance Imaging / methods*
  • Male
  • Muscle, Skeletal / anatomy & histology
  • Muscle, Skeletal / pathology
  • Pelvis / anatomy & histology
  • Pelvis / pathology*
  • Preoperative Care
  • Rectum / abnormalities*
  • Rectum / pathology
  • Rectum / surgery