Anna Russo MD, Abstract Co-Author: Nothing to Disclose

Martina Glida Pezzullo MD, Presenter: Nothing to Disclose

Alfonso Reginelli MD, Abstract Co-Author: Nothing to Disclose

Giulio Lombardi, Abstract Co-Author: Nothing to Disclose

Roberto Grassi MD, Abstract Co-Author: Nothing to Disclose

to compare the role of cine-dynamic MRI of pelvic floor and cine colpo-cysto-defecography (CCDRX ) in assessment of pelvic floor disorders

82 patients (21 males,61 females)aging from 26 to 80(mean age 53) were referred for CCDRX evaluation and then for cine-MRI examination of the pelvic floor. CCDRX was performed on a remote controlled commode connected to a videorecording system.Rectal ampulla,bladder and,in females,vagina were opacified and patient was seated on a dedicated commode, recording rest,contraction,straining and defecatory phases. MR examination was performed on a low field (0,22T) open strength magnet.T2-w sequences in axial,coronal and sagittal planes and,for dynamic study,T2-breath-hold sequence in sagittal plane,at rest and in contraction,straining and defecatory phases were performed.A phased array coil was used,so the patients were free to assume the gynaecological position,more comfortable than supine position to carry out the whole defecatory act.Rectum and,in female, vagina were filled with ultrasonographic gel mixed with Gd-DTPA. MR findings have been compared to cine CCDRX findings.

MRI detected 67 anterior rectocele,3 intracanalar mucosal prolapse ,16 recto-rectal intussusception,3 enterocele,12 parietal prolapse,28 cystocele,1 anal fistula,2 reduced anterior sphincter relaxation,4 negatives,1 borderline. CCDRX detected 37 anterior rectocele,1 anterior and posterior rectocele,32 intracanalar mucosal prolapse,16 recto-rectal intussusception,3 enterocele,26 parietal prolapse,2 anal fistula,2 reduced anterior sphincter relaxation,4 negatives.

Cine MRI allows a morpho-functional study of the entire pelvic floor with multiplanar visualization of the whole anatomic region without using IR,so that the entire sequence could be repeated if unsatisfactory for the radiologist,without any irradiation risk for the patient.Dynamic MRI reports better accuracy in characterization of endopelvic organs prolapse but lower sensibility than CCDRX in detecting mucosal alterations

pelvic floor disorders are more frequent in females than in men and are characterized for complex clinical presentations due to association of multiple pathologies

Russo, A, Pezzullo, M, Reginelli, A, Lombardi, G, Grassi, R, Dynamic MRI in Assessment of Pelvic Floor Disorders: Comparison with CCDRX.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5016610.html