title: Dynamic magnetic resonance imaging to quantify pelvic organ prolapse: reliability of assessment and correlation with clinical findings and pelvic floor symptoms.
abstract: OBJECTIVE
  The aim of this study was to assess the interobserver agreement of magnetic resonance imaging (MRI)-based staging of pelvic organ prolapse (POP) and to quantify associations between MRI-based POP staging, findings at pelvic examination, and pelvic floor symptoms.
  
  
  METHODS
  This was a cross-sectional study of ten symptomatic POP patients, ten symptomatic patients without POP, and ten nulliparous asymptomatic women. Three different observers performed MRI-based POP staging using the pubococcygeal line (PCL), midpubic line (MPL), perineal line, and H line as references.
  
  
  RESULTS
  The interobserver agreement of MRI-based staging of the anterior and middle compartment was good to excellent. In symptomatic women without prolapse, MRI-based and pelvic-examination-based POP staging were poorly correlated. In none of the women were MRI-based POP Quantification (POP-Q) staging and pelvic floor symptoms strongly associated.
  
  
  CONCLUSIONS
  The interobserver agreement of MRI-based POP staging is excellent, but the added clinical value of such staging is questionable due to poor association with clinical findings and pelvic floor symptoms.
authors.affiliation: Department of Obstetrics and Gynaecology, Academic Medical Centre, Room H4-205, PO Box 22700, 1105 DE, Amsterdam, The Netherlands. m.m.lakeman@amc.uva.nl
authors.forename: Mariëlle M E
authors.initials: MM
authors.lastname: Lakeman
authors.forename: F M
authors.initials: FM
authors.lastname: Zijta
authors.forename: J
authors.initials: J
authors.lastname: Peringa
authors.forename: A J
authors.initials: AJ
authors.lastname: Nederveen
authors.forename: J
authors.initials: J
authors.lastname: Stoker
authors.forename: J P W R
authors.initials: JP
authors.lastname: Roovers
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation; D017773:Pelvic Floor / Q000473:pathology*; D056887:Pelvic Organ Prolapse / Q000175:diagnosis* / Q000473:pathology*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index