title: Dynamic Magnetic Resonance Imaging and pelvic floor disorders: how and when?
abstract: Pelvic Floor Disorders (PFD) are a major public health problem in the world and decrease seriously the patient's quality of life. In case of recurrence after surgery or complex prolapse, imaging techniques can be used. Dynamic MRI, introduced in the early 1990s, offers information of the four compartments of the pelvis with a high resolution and a direct visualization of muscles and fascias in multiple planes. But for a practical use, such an expensive exam should be well correlated to symptoms and clinical examination or change surgical approach. The aim of our review was to precise the evidence regarding techniques, and indication of dynamic MRI in the assessment of pelvic floor disorders in daily practice. The first part is a review of available studies on methods of carrying out the dynamic MRI. The second part consists on the comparison of dynamic MRI to other assessment methods in case of pelvic floor disorders. Results emphasize the lack of strong level studies about the interest of dynamic MRI in the diagnosis and surgical management of pelvic organ prolapse. Although dynamic MRI appears highly reproducible between examiners, especially for the anterior compartment, its correlation with the degree of prolapse or the symptoms appears low. The most interesting field of application seems the detection of levator ani (LA) avulsion with a higher risk of prolapse and recidive in case of LA defects. More prospective, randomized, comparative studies have to be done.
authors.affiliation: Department of Gynaecology and Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France; Research Unit EA7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, Université Versailles St-Quentin, Montigny-le-Bretonneux, France. Electronic address: ac_pizzoferrato@yahoo.com.
authors.forename: Anne-Cécile
authors.initials: AC
authors.lastname: Pizzoferrato
authors.affiliation: Department of Gynaecology and Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France.
authors.forename: Krystel
authors.initials: K
authors.lastname: Nyangoh Timoh
authors.affiliation: Poitiers University, INSERM CIC1402, University Hospital of Poitiers, Poitiers, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Fritel
authors.affiliation: Department of Gynaecology and Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France.
authors.forename: Elise
authors.initials: E
authors.lastname: Zareski
authors.affiliation: Department of Gynaecology and Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France.
authors.forename: Georges
authors.initials: G
authors.lastname: Bader
authors.affiliation: Department of Gynaecology and Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France; Research Unit EA7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, Université Versailles St-Quentin, Montigny-le-Bretonneux, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Fauconnier
mesh_terms: D003672:Defecation; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D059952:Pelvic Floor Disorders / Q000175:diagnosis*; D056887:Pelvic Organ Prolapse / Q000175:diagnosis*; D020047:Rectocele / Q000175:diagnosis; D014550:Urinary Incontinence, Stress / Q000175:diagnosis
keywords: Magnetic resonance imaging; Pelvic floor dysfunction; Pelvic organ prolapse; Reliability; Urinary incontinence