MRI of pelvic floor dysfunction: dynamic true fast imaging with steady-state precession versus HASTE.
OBJECTIVE
The objective of our study was to retrospectively compare the degree of pelvic organ prolapse shown on dynamic true fast imaging with steady-state precession (FISP) versus HASTE sequences in symptomatic patients.


METHODS
Fifty-nine women (mean age, 57 years) with suspected pelvic floor dysfunction underwent MRI using both a sagittal true FISP sequence, acquired continuously during rest alternating with the Valsalva maneuver, and a sagittal HASTE sequence, acquired sequentially at rest and at maximal strain. Data sets were evaluated in random order by two radiologists in consensus using the pubococcygeal line (PCL) as a reference. Measurement of prolapse was based on a numeric grading system indicating severity as follows: no prolapse, 0; mild, 1; moderate, 2; or severe, 3. A comparison between sequences on a per-patient basis was performed using a Wilcoxon's analysis with p < 0.05 considered significant.


RESULTS
Overall, 66.1% (39/59) of patients had more severe prolapse (>or= 1 degrees ) based on dynamic true FISP images, with 28.8% (17/59) of the cases of prolapse seen exclusively on true FISP images. Only 20.3% (12/59) of patients had greater degrees of prolapse on HASTE images than on true FISP images, with 10.2% (6/59) of the cases seen exclusively on HASTE images. A statistically significant increase in the severity of cystoceles (p < 0.01) and urethral hypermobility (p < 0.01)-with a trend toward more severe urethroceles (p < 0.07), vaginal prolapse (p < 0.09), and rectal descent (p < 0.06)-was shown on true FISP images.


CONCLUSIONS
Overall, greater degrees of organ prolapse in all three compartments were found with a dynamic true FISP sequence compared with a sequential HASTE sequence. Near real-time continuous imaging with a dynamic true FISP sequence should be included in MR protocols to evaluate pelvic floor dysfunction in addition to dynamic multiplanar HASTE sequences.
Hecht
Elizabeth M
EM
Department of Radiology, New York University Medical Center, 560 First Ave., Ste. HW 202, New York, NY 10016, USA. hechte01@med.nyu.edu
Lee
Vivian S
VS
Tanpitukpongse
Teerath Peter
TP
Babb
James S
JS
Taouli
Bachir
B
Wong
Samson
S
Rosenblum
Nirit
N
Kanofsky
Jamie A
JA
Bennett
Genevieve L
GL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology*; D011391:Prolapse; D020047:Rectocele / Q000175:diagnosis; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014570:Urologic Diseases / Q000175:diagnosis; D014596:Uterine Prolapse / Q000175:diagnosis; D014636:Valsalva Maneuver