Sa1350 Magnetic Resonance Diffusion Tensor Imaging & Muscle Fiber Tractography Show Defects of the Transverse Perinea and Bulbospongiosus Muscles of the External Anal Sphincter Complex in Patient With Anal Incontinence

2015 ◽  
Vol 148 (4) ◽  
pp. S-299
Author(s):  
Ravinder K. Mittal ◽  
Melissa M. Ledgerwood ◽  
Shantanu Sinha
Keyword(s):  
Diffusion Tensor Imaging ◽  
Magnetic Resonance ◽  
Anal Sphincter ◽  
Muscle Fiber ◽  
Anal Incontinence ◽  
External Anal Sphincter ◽  
Diffusion Tensor ◽  
Fiber Tractography ◽  
Sphincter Complex ◽  
Anal Sphincter Complex

Mo1231 Magnetic Resonance Diffusion Tensor Imaging of the Anatomically Disrupted External Anal Sphincter: Comparison With Normal

2013 ◽  
Vol 144 (5) ◽  
pp. S-612
Author(s):  
Melissa Ledgerwood ◽  
Shantanu Sinha ◽  
Auroni Gupta ◽  
Valmik Bhargava ◽  
Ravinder K. Mittal
Keyword(s):  
Diffusion Tensor Imaging ◽  
Magnetic Resonance ◽  
Anal Sphincter ◽  
External Anal Sphincter ◽  
Diffusion Tensor

scholarly journals Purse-string morphology of external anal sphincter revealed by novel imaging techniques

2014 ◽  
Vol 306 (6) ◽  
pp. G505-G514 ◽  
Author(s):  
Ravinder K. Mittal ◽  
Valmik Bhargava ◽  
Geoff Sheean ◽  
Melissa Ledgerwood ◽  
Shantanu Sinha
Keyword(s):  
Anal Canal ◽  
Anal Sphincter ◽  
Muscle Fiber ◽  
Anal Incontinence ◽  
External Anal Sphincter ◽  
Diffusion Tensor ◽  
Imaging Techniques ◽  
Three Dimensional ◽  
Purse String ◽  
Lidocaine Injection

The external anal sphincter (EAS) may be injured in 25–35% of women during the first and subsequent vaginal childbirths and is likely the most common cause of anal incontinence. Since its first description almost 300 years ago, the EAS was believed to be a circular or a “donut-shaped” structure. Using three-dimensional transperineal ultrasound imaging, MRI, diffusion tensor imaging, and muscle fiber tracking, we delineated various components of the EAS and their muscle fiber directions. These novel imaging techniques suggest “purse-string” morphology, with “EAS muscles” crossing contralaterally in the perineal body to the contralateral transverse perineal (TP) and bulbospongiosus (BS) muscles, thus attaching the EAS to the pubic rami. Spin-tag MRI demonstrated purse-string action of the EAS muscle. Electromyography of TP/BS and EAS muscles revealed their simultaneous contraction and relaxation. Lidocaine injection into the TP/BS muscle significantly reduced anal canal pressure. These studies support purse-string morphology of the EAS to constrict/close the anal canal opening. Our findings have implications for the effect of episiotomy on anal closure function and the currently used surgical technique (overlapping sphincteroplasty) for EAS reconstructive surgery to treat anal incontinence.

scholarly journals The effect of vaginal delivery and Caesarean section on the anal Sphincter complex of Primipara based on optimized three-dimensional ultrasound image and nuclear regression Reconstruction Algorithm

2021 ◽  
Vol 37 (6-WIT) ◽  
Author(s):  
Naxin He ◽  
Liang Shi
Keyword(s):  
Caesarean Section ◽  
Anal Sphincter ◽  
External Anal Sphincter ◽  
Caesarean Delivery ◽  
Three Dimensional ◽  
Reconstruction Algorithm ◽  
Perineal Ultrasound ◽  
Central Plane ◽  
Sphincter Complex ◽  
Anal Sphincter Complex

Objective: The study used the optimized nuclear regression reconstruction algorithm to explore the value of three-dimensional perineal ultrasound evaluation of the effect of caesarean delivery and caesarean section on the anal sphincter complex of primipara. Methods: This study performed three-dimensional perineal ultrasound scanning of the anal sphincter complex of 157 primiparas 42 days after delivery. Among them, 77 were in caesarean delivery (spontaneous delivery group) and 80 were in caesarean section (caesarean delivery group) from September 2018 to December 2020 in our hospital. The thickness of the end plane, the middle plane, the distal plane and the distal plane of the external anal sphincter at 3, 6, 9, 12 o’clock direction, and measure the thickness of the central plane of the pubic rectum muscle at 4, 8 o’clock direction. At the same time, the study used tomography and volume contrast imaging to observe the morphology and integrity of the anal sphincter complex. Results: The thickness of the distal anal sphincter at the 12 o’clock direction, the proximal anal sphincter at 6, 12 o’clock, and the central plane at 9 and 12 o’clock in the obstetric group were smaller than those in the caesarean section group (all P < 0.05). There were no significant differences in the thickness of the remaining anal internal and external anal sphincter and puborectalis muscles between the two groups in different directions (all P>0.05). In the obstetric group, a perineal sphincter defect was found via three-dimensional perineal ultrasound. Conclusion: The delivery method has a certain influence on the shape of the anal sphincter complex. The thickness of the internal and external anal sphincter of the primiparous women in a certain direction is significantly smaller than that of caesarean section. Transperineally three-dimensional ultrasound can clearly show the morphological characteristics and integrity of the anal sphincter complex, and diagnose the defect of the anal sphincter complex. doi: https://doi.org/10.12669/pjms.37.6-WIT.4859 How to cite this:He N, Shi L. The effect of vaginal delivery and Caesarean section on the anal Sphincter complex of Primipara based on optimized three-dimensional ultrasound image and nuclear regression Reconstruction Algorithm. Pak J Med Sci. 2021;37(6):1641-1646.  doi: https://doi.org/10.12669/pjms.37.6-WIT.4859 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Diffusion Tensor Imaging with Three-dimensional Fiber Tractography of Traumatic Axonal Shearing Injury: An Imaging Correlate for the Posterior Callosal “Disconnection” Syndrome: Case Report

Neurosurgery ◽  
2005 ◽  
Vol 56 (1) ◽  
pp. E195-E201 ◽  
Author(s):  
Tuong H. Le ◽  
Pratik Mukherjee ◽  
Roland G. Henry ◽  
Jeffrey I. Berman ◽  
Marcus Ware ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Magnetic Resonance ◽  
Diffusion Tensor ◽  
Three Dimensional ◽  
Magnetic Resonance Images ◽  
Fiber Tractography ◽  
Disconnection Syndrome ◽  
Apparent Diffusion

Abstract OBJECTIVE: To demonstrate that magnetic resonance diffusion tensor imaging (DTI) with three-dimensional (3-D) fiber tractography can visualize traumatic axonal shearing injury that results in posterior callosal disconnection syndrome. METHODS: A 22-year-old man underwent serial magnetic resonance imaging 3 days and 12 weeks after blunt head injury. The magnetic resonance images included whole-brain DTI acquired with a single-shot spin echo echoplanar sequence. 3-D DTI fiber tractography of the splenium of the corpus callosum was performed. Quantitative DTI parameters, including apparent diffusion coefficient and fractional anisotropy, from the site of splenial injury were compared with those of a normal adult male volunteer. RESULTS: Conventional magnetic resonance images revealed findings of diffuse axonal injury, including a lesion at the midline of the splenium of the corpus callosum. DTI performed 3 days posttrauma revealed that the splenial lesion had reduced apparent diffusion coefficient and fractional anisotropy, reflecting a large decrease in the magnitude of diffusion parallel to the white matter fibers, which had partially recovered as revealed by follow-up DTI 12 weeks postinjury. 3-D tractography revealed an interruption of the white matter fibers in the posteroinferior aspect of the splenium that correlated with the patient's left hemialexia, a functional deficit caused by disconnection of the right visual cortex from the language centers of the dominant left hemisphere. CONCLUSION: DTI with 3-D fiber tractography can visualize acute axonal shearing injury, which may have prognostic value for the cognitive and neurological sequelae of traumatic brain injury.

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