Ulrike I. Attenberger MD, Presenter: Research Consultant, Bayer AG

John Nicholas Morelli MD, Abstract Co-Author: Nothing to Disclose

Alexander Herold, Abstract Co-Author: Nothing to Disclose

Peter Kienle MD, PhD, Abstract Co-Author: Nothing to Disclose

Werner Kleine, Abstract Co-Author: Nothing to Disclose

Axel Hacker, Abstract Co-Author: Nothing to Disclose

Christopher Baumann, Abstract Co-Author: Nothing to Disclose

Julia Heinzelbecker, Abstract Co-Author: Nothing to Disclose

Stefan Oswald Schoenberg MD, PhD, Abstract Co-Author: Institutional research agreement, Siemens AG

Henrik J. Michaely MD, Abstract Co-Author: Speakers Bureau, Siemens AG Speakers Bureau, Bayer AG Speakers Bureau, Guerbet SA

To determine the value of dynamic pelvic floor MRI relative to standard clinical examinations in treatment decisions made by an interdisciplinary team of specialists in a center for pelvic floor dysfunction

60 women were included in this IRB approved retrospective analysis. All patients were referred for dynamic pelvic floor MRI by an interdisciplinary team of specialists of a pelvic floor center. All patients were clinically examined by an urologist, gynecologist, a proctological and colorectal surgeon. The specialists assessed individually and in consensus, whether (1) MRI provides important additional information not evident by physical examination and in consensus whether (2) MRI influenced the treatment strategy and/or (3) changed management or the surgical procedure.

MRI was rated essential in the treatment decisions of 22/50 cases, leading to a treatment change in 13 cases. In 12 cases, an enterocele was diagnosed by MRI but was not detected on physical exam. In 4 cases an enterocele and in 2 cases a rectocele were suspected clinically but not confirmed by MRI. In 4 cases, MRI proved critical in assessment of rectocele size. Vaginal intussusception detected on MRI was likewise missed by gynecologic exam in 1 case.

MRI allows diagnosis of clinically occult enteroceles, by comprehensively evaluating the interaction between the pelvic floor and viscera. In nearly half of cases, MRI changed management or the surgical approach relative to the clinical evaluation of an interdisciplinary team. Thus, dynamic pelvic floor MRI represents an essential component of the evaluation for pelvic floor disorders.

In an interdisciplinary center for pelvic floor disorders dynamic pelvic floor MRI leads to a significant change in clinical management

Attenberger, U, Morelli, J, Herold, A, Kienle, P, Kleine, W, Hacker, A, Baumann, C, Heinzelbecker, J, Schoenberg, S, Michaely, H, The Value of Dynamic Magnetic Resonance Imaging in Interdisciplinary Treatment of Pelvic Floor Dysfunction.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13017928.html