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MRI in Evaluating Atrophy of the External Anal Sphincter in Patients with Fecal Incontinence

Maaike P. Terra1, Regina G. H. Beets-Tan2, Victor P. M. van der Hulst3, Marije Deutekom4, Marcel G. W. Dijkgraaf4, Patrick M. M. Bossuyt4, Annette C. Dobben1, Cor G. M. I. Baeten5 and Jaap Stoker1

1 Department of Radiology, Academic Medical Center, Meibergdreef 9, Amsterdam, The Netherlands 1105 AZ.
2 Department of Radiology, University Hospital Maastricht, Maastricht, The Netherlands.
3 Department of Radiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
4 Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, The Netherlands.
5 Department of Surgery, University Hospital Maastricht, Maastricht, The Netherlands.


Figure 1
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  		Fig. 1A —68-year-old man with fecal incontinence and diabetes mellitus. MR images show normal anatomy of external anal sphincter (EAS) and internal anal sphincter (IAS). Neither thinning of EAS muscle nor diffuse replacement of EAS muscle by fat is seen. C = endoanal coil. Transverse endoanal T2-weighted fast spin-echo image (TR/TE, 2,500/70).

 

Figure 2
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  		Fig. 1B —68-year-old man with fecal incontinence and diabetes mellitus. MR images show normal anatomy of external anal sphincter (EAS) and internal anal sphincter (IAS). Neither thinning of EAS muscle nor diffuse replacement of EAS muscle by fat is seen. C = endoanal coil. Coronal endoanal T2-weighted fast spin-echo image (2,500/70).

 

Figure 3
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  		Fig. 1C —68-year-old man with fecal incontinence and diabetes mellitus. MR images show normal anatomy of external anal sphincter (EAS) and internal anal sphincter (IAS). Neither thinning of EAS muscle nor diffuse replacement of EAS muscle by fat is seen. C = endoanal coil. Transverse external phased-array T2-weighted fast spin-echo image (2,500/70).

 

Figure 4
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  		Fig. 1D —68-year-old man with fecal incontinence and diabetes mellitus. MR images show normal anatomy of external anal sphincter (EAS) and internal anal sphincter (IAS). Neither thinning of EAS muscle nor diffuse replacement of EAS muscle by fat is seen. C = endoanal coil. Coronal external phased-array T2-weighted fast spin-echo image (2,500/70).

 

Figure 5
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  		Fig. 2A —68-year-old woman with fecal incontinence. MR images show severe thinning of external anal sphincter (EAS) muscle and diffuse replacement of EAS muscle by fat. This patient had neurologic disorder (spinal) in past. IAS = internal anal sphincter, C = endoanal coil. Coronal endoanal T2-weighted fast spin-echo image (TR/TE, 2,500/70).

 

Figure 6
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[in a new window]
  		Fig. 2B —68-year-old woman with fecal incontinence. MR images show severe thinning of external anal sphincter (EAS) muscle and diffuse replacement of EAS muscle by fat. This patient had neurologic disorder (spinal) in past. IAS = internal anal sphincter, C = endoanal coil. Coronal external phased-array T2-weighted fast spin-echo image (2,500/70).

 

Figure 7
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  		Fig. 3A —46-year-old man with fecal incontinence and history of neurologic disorder (spinal). MR images show severe thinning of external anal sphincter (EAS) muscle and diffuse replacement of EAS muscle by fat. IAS = internal anal sphincter, C = endoanal coil. Transverse endoanal T2-weighted fast spin-echo image (TR/TE, 2,500/70).

 

Figure 8
View larger version (126K):

[in a new window]
  		Fig. 3B —46-year-old man with fecal incontinence and history of neurologic disorder (spinal). MR images show severe thinning of external anal sphincter (EAS) muscle and diffuse replacement of EAS muscle by fat. IAS = internal anal sphincter, C = endoanal coil. Transverse external phased-array T2-weighted fast spin-echo image (2,500/70).

 

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