Articles Vol. 67 No. 9 25/09/2026

AGREEMENT BETWEEN HIGH-RESOLUTION ANORECTAL MANOMETRY AND MAGNETIC RESONANCE DEFECOGRAPHY IN OBSTRUCTED DEFECATION SYNDROME

Pham Phuong Thao, Tran Ngoc Anh, Nguyen Thi Chi, Ngo Gia Manh, Bui Tuan Dat, Vu Thi Dung, Hoang Dinh Au
DOI: 10.52163/yhc.v67i9.6747
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Abstract

Purpose: To evaluate the agreement between HR-ARM and MRD in the assessment of defecatory disorders in patients with chronic constipation.

Methods: A cross-sectional study was conducted on 42 patients diagnosed with functional constipation according to Rome IV criteria. All patients underwent HR-ARM and MRD. The agreement between dyssynergia subtypes on HR-ARM and MRI findings was assessed using Cohen’s Kappa coefficient.

Results: The majority of patients were female (85.7%) and aged ≥50 years. The most common symptom was a sensation of outlet obstruction (85.7%). Overall agreement between HR-ARM and MRD was low. Only type 2 dyssynergia showed moderate agreement with MRI-diagnosed anismus (Kappa = 0.45), while other subtypes demonstrated poor or no agreement (Kappa ranging from negative values to near zero). No significant agreement was observed between dyssynergia subtypes and structural abnormalities, including pelvic floor descent, rectocele, and rectal intussusception (Kappa ≈ 0).

Conclusion: HR-ARM and MRD assess different aspects of defecatory disorders, reflecting functional and structural–dynamic abnormalities, respectively. These modalities are complementary rather than interchangeable; the choice to combine them should be guided by clinical symptoms, initial test results, and treatment orientation to enhance diagnostic value in obstructed defecation syndrome.

Keywords
Chronic constipation; HR-ARM; MR defecography; defecatory disorders.
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