title: Dynamic pelvic floor MR imaging at 3 T in patients with clinical signs of urinary incontinence-preliminary results.
abstract: To prospectively evaluate feasibility, image quality and diagnostic accuracy of dynamic MR imaging the pelvic floor at 3.0 T in patients with urinary incontinence and to compare these results with those of MRI performed at 1.5 T. Ten patients with the diagnosis of urinary incontinence (clinical symptoms, clinical examination, pelvic ultrasound) were examined with a dynamic balanced FFE (B-FFE) sequence at 1.5 T and 3.0 T on the same day in a randomized order. Spatial (1.5 x 1.5 x 8 mm) and temporal (0.44 s) resolution at 3.0 T were comparable to the 1.5-T B-FFE sequence. Two radiologists assessed visual signal to noise (three-point scale), artefact level (five-point scale) and final MR diagnoses with regard to pelvic floor weakness (independent analysis). The diagnoses obtained at 1.5-T field strength and the results of the clinical tests served as standard of reference. In addition, ROI-based quantitative measurements were performed to assess different tissue contrasts at both field strengths. Data were analyzed for statistical differences by using the Wilcoxon's matched pairs test and the marginal homogeneity test. Visual signal to noise was rated higher at 3.0 T for all ten studies by both radiologists. With regard to artefact level, there was no statistically significant difference between the studies obtained at 3.0 T as compared to the corresponding 1.5-T studies (marginal homogeneity test: p = 0.18 for reviewer 1 and 0.41 for reviewer 2). Mean artefact level was rated minor to moderate by both reviewers for both field strengths (excellent interobserver agreement with Kendall-W value of 0.973). Except for a higher tissue contrast between fat and urethra at 1.5 T, there were no statistically significant differences between tissue contrast at 1.5 T as compared to 3.0 T (Wilcoxon's test). Final MR diagnoses regarding pelvic floor weakness did not differ between 3.0-T and 1.5-T field strength and correlated well with the results of the clinical tests. Dynamic pelvic floor MR imaging is feasible at 3.0 T. Our preliminary data indicate that evaluation of pelvic floor disease seems to be possible with 3.0 T equally well as compared to 1.5 T.
authors.affiliation: Department of Radiology, University of Bonn, Bonn, Germany. n.morakkabati@uni-bonn.de
authors.forename: Nuschin
authors.initials: N
authors.lastname: Morakkabati-Spitz
authors.forename: Jürgen
authors.initials: J
authors.lastname: Gieseke
authors.forename: Winfried A
authors.initials: WA
authors.lastname: Willinek
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Bastian
authors.forename: Bettina
authors.initials: B
authors.lastname: Schmitz
authors.forename: Frank
authors.initials: F
authors.lastname: Träber
authors.forename: Ursula
authors.initials: U
authors.lastname: Jaeger
authors.forename: Stefan C
authors.initials: SC
authors.lastname: Mueller
authors.forename: Hans H
authors.initials: HH
authors.lastname: Schild
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017773:Pelvic Floor / Q000473:pathology*; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014549:Urinary Incontinence / Q000175:diagnosis*