title: MRI diagnosis of pelvic organ prolapse compared with clinical examination.
abstract: OBJECTIVE
  The aims of this study were to determine agreement between clinical examination and magnetic resonance imaging (MRI) (rectal contrast and noncontrast MRI) for pelvic organ prolapse using both the pubococcygeal line (PCL) and the midpubic line (MPL) and to assess the relationship between measurements performed relative to each line.
  
  
  METHODS
  Dynamic MRI exams in 88 women (with rectal contrast, n = 39; noncontrast, n = 49) were evaluated, followed by review of clinical exam notes. Agreement between clinical exam and MRI and the difference between PCL and MPL measurements were evaluated.
  
  
  RESULTS
  Agreement of rectal contrast MRI with clinical exam was 79% for PCL and 85% for MPL (P = .17) for cystoceles, 50% for PCL and 59% for MPL (P = .20) for vaginal prolapse, 56% for PCL for enteroceles, and 61% for rectoceles. Agreement of noncontrast MRI with clinical exam was 67% for PCL and 78% for MPL (P = .19) for cystoceles, 58% for PCL and 71% for MPL (P = .10) for vaginal prolapse, 65% for enteroceles, and 40% for rectoceles. The average difference between the PCL and the MPL was 3.12 ± 0.24 cm at the bladder base and 4.88 ± 0.37 cm at the vaginal apex.
  
  
  CONCLUSIONS
  Agreement of MRI with clinical exam was highest for cystoceles. There was no significant difference in agreement using the MPL or PCL, suggesting that either line can be used on MRI. The average differences between the PCL and MPL at the bladder base and vaginal apex were approximately 3 and 5 cm, respectively.
authors.affiliation: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA. pannuh@mskcc.org
authors.forename: Harpreet K
authors.initials: HK
authors.lastname: Pannu
authors.forename: John C
authors.initials: JC
authors.lastname: Scatarige
authors.forename: John
authors.initials: J
authors.lastname: Eng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000175:diagnosis*; D010808:Physical Examination; D012007:Rectum; D012044:Regression Analysis
chemical_list: D003287:Contrast Media