Figure 1.
Midsagittal MR images obtained with the closed-configuration system in a 65-year-old man with a final diagnosis of dyssynergic defecation (a) On steady-state free-precision images (5.7/2.6) obtained at (a) rest, the anorectal angle measures 94°. (b, c) T1 weighted multiphase fast-spoiled gradient-recalled echo images (8.4/2.1) show a decrease in the anorectal angle during straining (77°) (b) and during evacuation (69°) (c). In addition, paradoxical sphincter contraction is noted with impression of the dorsal anorectal wall during straining and evacuation (white arrow in b and c). White lines in a, b and c show anorectal angle measurements. The patient was able to evacuate only less than two-thirds of the contrast agent.