RSNA 2003 

Abstract Archives of the RSNA, 2003


T03-1410

Role of Dynamic MRI Compared with Functional Static MRI in the Assessment of Pelvic Floor Disorders

Scientific Papers

Presented on December 5, 2003
Presented as part of T03: Gastrointestinal (Colon: MR Colonography, Pelvic Floor Imaging)

Participants

Maria Chiara Colaiacomo MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: To evaluate the role of dynamic MRI compared with functional static MRI in the assessment of pelvic floor disorders. Methods and Materials: Forty patients (32 f, 8 m) with clinical and/or instrumental (conventional defecography, manometry) evidence of posterior pelvic floor (PPF) disorders underwent 1.5 T MRI, using a conventional magnet in supine position. A Fooley catheter was introduced in the rectum filling the end-balloon with water, as a mark of the ano-rectum junction. For the static functional MR study six consecutive T2 weighted HASTE (Half Fourier SingleShot Turbo SE) sequences (20 slices/ 20 seconds) were acquired during rest, anal sphincters contractions and straining in the axial and sagittal plane. Examination time was approximately 8 minutes. For the dynamic study, the T2-weighted HASTE sequence was modified, acquiring 1 image in the midsagittal plane per second for 20 times, starting at rest, then asking the patient to contract the pelvic floor muscles, and subsequently straining progressively to a maximum, for a 25-seconds overall acquisition time. MR findings were inter-correlated and correlated with conventional defecography. Two radiologists blind of the clinical results and defecography separately analyzed MR images. Results: MR revealed 12 rectoceles, 20 anorectal junction descents, 5 rectal prolapses, 3 diskinetic pelvic floor, 2 enteroceles, 7 uterine descents, 9 cystoceles, 3 perianal pathologies (abscesses, anal fistulas). All these findings were consistent to clinical, conventional defecography and manometry findings. Results obtained with functional MRI were not statistically different from those obtained with dynamic MRI. Functional MR examination, by using different imaging planes, provided additional information on the sphincters, elevator ani, puborectalis muscles, uterine prolapses and enteroceles. Conclusion: MRI defecography is a valuable tool in the diagnosis of pelvic floor disorders. In our experience the dynamic T2 weighted HASTE 25 seconds sequence is accurate for PPF disorders, fast and well accepted. Static functional MRI provides more detailed informations on the pelvic structures and pelvic floor muscles.       Questions about this event email: francesca.maccioni@uniroma1.it

Cite This Abstract

Colaiacomo MD, M, Role of Dynamic MRI Compared with Functional Static MRI in the Assessment of Pelvic Floor Disorders.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3104933.html