title: Magnetic resonance imaging of pelvic floor dysfunction - joint recommendations of the ESUR and ESGAR Pelvic Floor Working Group.
abstract: OBJECTIVE
  To develop recommendations that can be used as guidance for standardized approach regarding indications, patient preparation, sequences acquisition, interpretation and reporting of magnetic resonance imaging (MRI) for diagnosis and grading of pelvic floor dysfunction (PFD).
  
  
  METHODS
  The technique included critical literature between 1993 and 2013 and expert consensus about MRI protocols by the pelvic floor-imaging working group of the European Society of Urogenital Radiology (ESUR) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) from one Egyptian and seven European institutions. Data collection and analysis were achieved in 5 consecutive steps. Eighty-two items were scored to be eligible for further analysis and scaling. Agreement of at least 80 % was defined as consensus finding.
  
  
  RESULTS
  Consensus was reached for 88 % of 82 items. Recommended reporting template should include two main sections for measurements and grading. The pubococcygeal line (PCL) is recommended as the reference line to measure pelvic organ prolapse. The recommended grading scheme is the "Rule of three" for Pelvic Organ Prolapse (POP), while a rectocele and ARJ descent each has its specific grading system.
  
  
  CONCLUSIONS
  This literature review and expert consensus recommendations can be used as guidance for MR imaging and reporting of PFD.
  
  
  CONCLUSIONS
  • These recommendations highlight the most important prerequisites to obtain a diagnostic PFD-MRI. • Static, dynamic and evacuation sequences should be generally performed for PFD evaluation. • The recommendations were constructed through consensus among 13 radiologists from 8 institutions.
authors.affiliation: Genitourinary & Pelvic Floor MR Imaging Unit, Department of Radiology, Faculty of Medicine, Cairo University Hospitals, Cairo, Egypt. rania729.re@gmail.com.
authors.forename: Rania Farouk
authors.initials: RF
authors.lastname: El Sayed
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Duesseldorf, Germany.
authors.forename: Celine D
authors.initials: CD
authors.lastname: Alt
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology Policlinico Umberto I Hospital, Sapienza University Rome, Viale Regina Elena, Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Maccioni
authors.affiliation: Department of Radiology, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
authors.forename: Matthias
authors.initials: M
authors.lastname: Meissnitzer
authors.affiliation: Department of Radiology Dea, Umberto I Hospital, Sapienza University of Rome, Viale del Policlinico, Rome, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Masselli
authors.affiliation: Department of Radiological Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena, Rome, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Manganaro
authors.affiliation: Department of Radiological Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena, Rome, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Vinci
authors.affiliation: Institute of Radiology and Nuclear Medicine, Triemli Hospital Zurich, Zurich, Switzerland.
authors.forename: Dominik
authors.initials: D
authors.lastname: Weishaupt
mesh_terms: D019841:Defecography / Q000379:methods; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D017773:Pelvic Floor / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D056887:Pelvic Organ Prolapse / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011860:Radiography, Abdominal / Q000379:methods; D020047:Rectocele / Q000000981:diagnostic imaging / Q000503:physiopathology
keywords: ESGAR; ESUR; MR defecography; MRI pelvic floor; Recommendations