Magnetic resonance imaging

Imaging is an integral part of the workup of patients with fecal incontinence. Endoanal ultrasound (EAUS) and endoanal magnetic resonance imaging (MRI) have been demonstrated to be comparable in the detection of external sphincter defects. Given the availability and costs, EAUS can be considered as an initial imaging test for detecting external sphincter defects in patients with fecal incontinence. Endoluminal MRI can be used as an alternative. Endoanal MRI is advantageous as compared to EAUS in demonstrating and grading external sphincter atrophy. External sphincter atrophy at endoanal MRI has been demonstrated to be a negative predictor of the outcome of anterior anal repair. In candidates for anterior anal repair, endoluminal MRI should be considered, to identify patients with external sphincter atrophy. External phased array coil MRI can replace endoluminal MRI in experienced hands.