[The role of medical imaging in the exploration of pelvic floor disorders].
Colpocystodefecography (CCD) and dynamic MRI with defecography (MRId) permit an alternation between filling and emptying the hollow organs and the maximum abdominal strain offered by the defecation. The application in imaging of these two principles reveal the masked or underestimated prolapses at the time of the physical examination. Rigorous application of the technique guarantees almost equivalent results from the two examinations. The CCD provides voiding views and improved analysis of the anorectal pathology (intussusceptions, anismus) but involves radiation and a more invasive examination. MRId has the advantage of providing continuous visibility of the peritoneal compartment, and a multiplanar representation, enabling an examination of the morphology of the pelvic organs and of the supporting structures, but with the disadvantage of still necessitating a supine examination, resulting sometimes in an incomplete evacuation. The normal and abnormal results (cystoptosis, vaginal vault prolapse, enterocele, anorectal intussuception, rectocele, descending perineum, urinary and fecal incontinence) and the respective advantages and the limits of the various imaging methods are detailed. Morphological and dynamic imaging are essential complementary tools to the physical examination, especially when a precise anatomic assessment is required to understand the functional complaint or when a reintervention is needed.
Lapray
J-F
JF
Centre de Radiologie, 151 Avenue de Saxe, 69003 Lyon, France. lapray@wanadoo.fr
Costa
P
P
Delmas
V
V
Haab
F
F
D003952:Diagnostic Imaging; D005260:Female; D052776:Female Urogenital Diseases / Q000175:diagnosis*; D006801:Humans; D017773:Pelvic Floor; D012002:Rectal Diseases / Q000175:diagnosis*