Pelvic floor descent: dynamic MR imaging using a half-Fourier RARE sequence.
Dynamic magnetic resonance imaging (MRI) using a single shot fast spin-echo technique was evaluated as a noninvasive alternative to cystourethography or colpocystorectography in patients with pelvic organ prolapse and/or urinary incontinence. Thirty-two patients were included in this prospective study. Colpocystorectography was performed in 10 patients who previously had undergone hysterectomy and in 2 patients without history of hysterectomy with clinical suspicion of rectoceles. Bead-chain cystourethrography was performed in 20 patients without hysterectomy. For dynamic MRI, a single-slice half-Fourier RARE sequence (imaging time 2 seconds) was used to depict the pelvic organs at different levels of pelvic strain. The results obtained with dynamic MRI were correlated with the x-ray findings. All 17 cystoceles, 10 rectoceles, 2 enteroceles, and 7 vaginal prolapses could be demonstrated on MRI. Diagnostic information gained from these images was equivalent to that obtained with colpocystorectography and superior to that obtained with cystourethrography; with the latter, important findings were missed (four rectoceles). We conclude that dynamic MRI of the pelvic floor with a half-Fourier RARE sequence can reliably detect descents of all three pelvic compartments, that it requires no contrast agent, and that no radiation exposure is involved.
Gufler
H
H
Radiology Department, Albert-Ludwigs-Universität, Freiburg, Germany.
Laubenberger
J
J
DeGregorio
G
G
Dohnicht
S
S
Langer
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005583:Fourier Analysis; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D017773:Pelvic Floor / Q000473:pathology; D011859:Radiography; D012005:Rectal Prolapse / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D001745:Urinary Bladder Diseases / Q000175:diagnosis*; D014549:Urinary Incontinence / Q000209:etiology*; D014596:Uterine Prolapse / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging