Role of magnetic resonance defecography in the assessment of obstructed defecation syndrome

Figure 11  Dyssynergic defecation. A: Sagittal true fast imaging with steady-state free precession image at rest shows an obtuse anorectal angle (ARA); B: During the squeeze maneuver the ARA reduces; C: During the strain phase, there is further reduction in the ARA with the prominent pubococcygeal muscle (yellow arrow) indenting the posterior wall of the anorectal junction; D: During defecation, the anorectal junction shows further indentation (yellow arrow) by the puborectalis muscle, which further reduces the ARA.