Dynamic MR Imaging of the Pelvic Floor in Asymptomatic Subjects
- 1 March 2000
- journal article
- Published by American Roentgen Ray Society in American Journal of Roentgenology
- Vol. 174 (3) , 661-666
- https://doi.org/10.2214/ajr.174.3.1740661
Abstract
OBJECTIVE. Dynamic MR imaging may be used as an alternative to dynamic cystoproctography for the evaluation of pelvic floor prolapse and configuration. MR criteria for normality are derived from proctographic studies because no large MR study of asymptomatic individuals has been performed. Our study aimed to define the normal range of dynamic pelvic MR appearances in a large group of asymptomatic individuals. SUBJECTS AND METHODS. Fifty healthy adult volunteers (25 men and 25 women; age range, 20-66 years; mean age, 34 years) were prospectively recruited and examined using dynamic MR imaging. All subjects were interviewed and established as healthy using a validated questionnaire. Axial, coronal, and sagittal MR imaging was performed at rest and during maximum pelvic strain using a static 1.0-T unit and a fast-field-echo sequence, providing 10 slices in 31 sec. Standardized measurements of pelvic configuration were taken, and rest and strain imaging were compared to determine the range of normal appearances. RESULTS. Three women developed a cystocele during maximum pelvic strain, two of whom also showed grade 1 uterocervical prolapse, which was also seen in another woman. Three men showed posterior pelvic floor descent in excess of 3 cm during straining. No rectocele, enterocele, rectal prolapse, or perineal hernia was seen in any subject. CONCLUSION. The normal range of pelvic organ descent in asymptomatic subjects seen on dynamic MR imaging included cystocele, uterocervical prolapse, and excessive anorectal junction descent. Although we encountered pelvic prolapse in seven volunteers, it was infrequent and low grade, suggesting that criteria for abnormality derived from proctography are generally applicable to MR imaging.Keywords
This publication has 22 references indexed in Scilit:
- Size of the urogenital hiatus in the levator ani muscles in normal women and women with pelvic organ prolapse*1Published by Wolters Kluwer Health ,1998
- Magnetic resonance imaging of the pelvic floor in patients with obstructed defaecationBritish Journal of Surgery, 1997
- Dynamic cystoproctography and physiological testing in women with urinary stress incontinence and urogenital prolapseClinical Radiology, 1996
- Imaging of anorectal functionThe British Journal of Radiology, 1996
- Dynamic cystoproctography: a technique for assessing disorders of the pelvic floor in women.American Journal of Roentgenology, 1994
- Bowel dysfunction: a pathogenic factor in uterovaginal prolapse and urinary stress incontinenceBJOG: An International Journal of Obstetrics and Gynaecology, 1994
- Anal-Sphincter Disruption during Vaginal DeliveryNew England Journal of Medicine, 1993
- ColpocystodefecographyDiseases of the Colon & Rectum, 1993
- Defecography in normal volunteers: results and implications.Gut, 1989
- Evacuation proctography: An investigation of rectal expulsion in 20 subjects without defecatory disturbanceAbdominal Radiology, 1988