By Mario Pescatori, Francisco Sérgio Pinheiro Regadas, Sthela Maria Murad Regadas, Andrew P. Zbar, Clive I. Bartram, Robert D. Madoff
The aim of this atlas, edited and authored by way of the world over revered specialists within the box, is to obviously and accurately current symptoms, innovations, obstacles, assets of blunders, and pitfalls of various imaging modalities. The textual content describes the ample, high quality pictures that express the conventional anorectal anatomy in addition to the pathological visual appeal of the all-too-common large-bowel and pelvic ground practical ailments. using radiopaque markers in diagnosing colonic inertia; defecography, 3D US, and MRI in investigating obstructed defecation; 3D US and MRI in differentiating among benign and malignant anorectal neoplasms; CT and MRI in assessing pelviperineal anatomy and opting for pelvic tumors and inflammatory procedures; and 2D-3D US in selecting acceptable therapy for fecal incontinence are mentioned intensive. This atlas demonstrates the worth of a workforce technique among colorectal surgeons and radiologists for fixing advanced scientific issues of the anorectum and PF.
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Extra info for Imaging Atlas of the Pelvic Floor and Anorectal Diseases
Interpretation of 3-D imaging is simpler, as muscle length can also be measured longitudinally. The exact identification of the injured muscles is important in deciding upon the best therapeutic option. Anal US can also be useful in evaluating the results of surgical repair, identifying adjacent or overlapping muscles, and documenting persisting muscle injury. Introduction Whereas 2-D endoanal ultrasound (US) scanning identifies injured muscles and the extent of the injury in relation to the anal circumference, 3-D scanning shows it in relation to anal canal length [1–3].
Secondary changes to the architecture of adjacent structures (longitudinal muscle, perianal fat) (Fig. 4) provide supportive evidence of a sphincter tear, where the contralateral side may be atrophic or normal when compared with the side of the tear. Variations in normal anatomy of the anal sphincter may be misdiagnosed as sphincter defects, with constitutive differences in the EAS being observed. The lower edge of the EAS often does not form a complete ring and can easily be misdiagnosed as a defect at this level – an effect that has also been reported with endoanal sonography .
6 a, b. a Pubococcygeus, b ileococcygeus, c anococcygeal ligament (see Figs. E. R. Pena, B. S. Kaufman Fig. 7. Levator muscles: coronal view. These muscles appear as shoulders on each side of the rectum, separating pelvic organs from the extrapelvic region Fig. 8. Pelvis: sagittal view. Demonstrates Waldeyer’s fascia (arrows) formed at the point of fusion of the fascia propria of the rectum and the presacral fascia Fig. 9. Pelvis: sagittal view. Shows the anococcygeal ligament (arrows) Coronal and Sagittal Anatomy MRI offers three views of the pelvic anatomy: (1) axial, (2) coronal, and (3) sagittal.