MRI of pelvic floor dysfunction: review.

Department of Diagnostic Radiology, Singapore General Hospital, Outram Rd., Singapore 169608, Republic of Singapore.
American Journal of Roentgenology (Impact Factor: 2.9). 12/2008; 191(6 Suppl):S45-53. DOI: 10.2214/AJR.07.7096
Source: PubMed

ABSTRACT OBJECTIVE: The purpose of this article is to review the anatomy and etiology of pelvic floor weakness in women and to discuss the role of MRI in the assessment of female pelvic floor dysfunction. CONCLUSION: In women with pelvic floor weakness, pelvic MRI, with its superior soft-tissue contrast resolution, allows direct visualization of the pelvic organs and their supportive structures in a single noninvasive examination. By providing useful and valuable information on the extent and severity of pelvic organ prolapse, MRI plays a valuable role in preoperative planning of complex cases.

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    ABSTRACT: To prove a basic physiological principle in healthy women, demonstrating different movement patterns of diaphragm, pelvic floor, and muscular wall surrounding the abdominal cavity during a Valsalva maneuver as opposed to a straining maneuver, by means of real-time dynamic magnetic resonance imaging (MRI). The study was performed at Hochzirl Hospital, Austria and Department of Radiology, Medical University Innsbruck, Austria. Four healthy women underwent MRI measurements in a 1.5-T whole body MR-scanner. Coronal, sagittal, and axial slices were acquired simultaneously and a dynamic MRI sequence was used to assess cranio-caudal movements of the diaphragm and pelvic floor and of concomitant changes in anterolateral abdominal muscle thickness and abdominal diameter at the umbilical level. Both the Valsalva maneuver and the straining maneuver began with deep inspiration and downward movement of the diaphragm. During the exertion phase of both maneuvers, abdominal muscle thickness increased and abdominal diameter decreased. During the Valsalva maneuver, the pelvic floor moved cranially parallel to the diaphragm, whereas during the straining maneuver, the pelvic floor was markedly displaced caudally. The Valsalva maneuver reflects an expiratory pattern with diaphragm and pelvic floor elevation, whereas during straining the pelvic floor descends.
    European journal of obstetrics, gynecology, and reproductive biology 07/2012; 164(2):227-33. · 1.97 Impact Factor
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    ABSTRACT: Introduction Pelvic floor dysfunction and prolapse affect about 50% of women past middle age. Failure to recognize the complex set of pelvic floor defects in individuals leads to most postsurgical failures. Diagnosis and grading of pelvic floor dysfunction is primarily done by physical examination. Imaging does not have yet an established role in the investigation of prolapse, yet it is expected to play a role in preoperative planning identifying soft tissue abnormalities which will help avoiding recurrence. Aim of the work This is a prospective study targeted at defining the role of MRI in assessment of pelvic floor prolapse in females. Methods Dynamic and static MRI was performed in 40 female patients complaining of pelvic organ prolapse and/or stress urinary incontinence or fecal incontinence. Full history was taken and clinical examination performed and findings compared with MRI results. Results Good concordance was found between dynamic MRI and clinical examination in all three compartments, it was 82.5% in the anterior compartment, 80% in the posterior compartment, 85% in enteroceles and 65.0% in the middle compartment. Conclusion Dynamic MRI is expected to be a promising imaging tool and to play a larger role in the preoperative planning of pelvic organ prolapse in the near future.
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    ABSTRACT: The objective of this study is to compare levator hiatus measurements between pelvic magnetic resonance imaging (MRI) and pelvic ultrasound (US) imaging modalities.
    Female pelvic medicine & reconstructive surgery. 07/2014; 20(4):216-221.