Abstract:
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Purpose: Morphological and functional changes of the pelvic floor with functional MRI in primiparous women after spontaneous vaginal delivery.
Methods and Materials: The study group consisted of 26 primiparous women after vaginal delivery. 41 healthy asymptomatic nulliparous volunteers were assigned to the control group. Functional MRI was performed on a 1.5T system (Magnetom Vision, Siemens, Germany) in the supine position with opacification of the vagina and rectum using ultrasound gel. Midsagittal and axial TrueFISP images were acquired with the patient at rest, straining and during defecation. Evaluation of morphometric parameters included among others: pelvimetry, thickness of puborectal muscle, width of urogenital hiatus, position and movement of pelvic organs using the pubococcygeal reference line.
Results: In the study group functional MRI was done averagely 85 days after delivery (50-164 days, SD 26.3).The configuration of the bony pelvis did not differ for both groups. The puborectal muscle was significantly thinner in the study group (0.8cm vs 0.6cm). At rest no significant differences were found between the two groups. However, during straining the bladder neck, vaginal fornix and anorectal junction showed a significant descent in the study group and declined below the pubococcygeal reference line more often than in the control group. In addition primiparous women exhibited more prominent rectoceles (0.6cm vs 1.5cm).
Conclusion: Static imaging alone is not sufficient to demonstrate pelvic floor changes. A functional method is necessary to evaluate the interactions of the pelvic organs regarding an organ descent. Functional MRI of the pelvic floor is an excellent method to reveal the significant changes of the pelvic floor after vaginal birth without exposure to radiation.
Questions about this event email: tanja.fischer@ikra.med.uni-muenchen.de
Fischer MD, T,
Functional MRI of the Pelvic Floor: Postpartal Changes in Primiparous Women after Vaginal Delivery. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3101137.html
