Yanbang Lian, Presenter: Nothing to Disclose

Zhiyang Zhou PhD, Abstract Co-Author: Nothing to Disclose

Zhengjun Liu MD, Abstract Co-Author: Nothing to Disclose

Jianping Qiu, Abstract Co-Author: Nothing to Disclose

pan zhu, Abstract Co-Author: Nothing to Disclose

Wuteng CAO, Abstract Co-Author: Nothing to Disclose

To study the anatomical and functional changes of normal female pelvic floors with high resolution dynamic MR defecography at rest, lift and defecation phases to establish an initial normal criteria for the diagnosis of pelvic floor dysfunction.

Ninety six young female volunteers, aged 20-30 years with a mean of 23.8±2.0 underwent the high resolution dynamic MRI defecography. Dynamic fast imaging employing steady-state acquisition sequence was performed in mid-sagittal plane at rest, lift and defecation phases. The distance between bladder neck, cervix, peritoneum, anal-rectal junction, sigmoid colon, small intestine to pubococcygeal line (PCL) were measured. Paired samples t test was carried out to compare the quantitative data.

The distance of anal-rectal junction, bladder neck, cervix, peritoneum, sigmoid colon, small intestine to PCL at rest phase were: (0.05±7.51)mm, (-23.80±3.34)mm, (-35.15±6.27)mm, (-40.07±6.53)mm, (-60.59±18.14)mm and (-67.65±13.48)mm, respectively. The measurements at lift phase were: (-9.11±4.77)mm, (-25.55±3.72)mm, (-35.74±6.06)mm, (-39.40±5.98)mm, (-63.76±10.29)mm and (-66.60±13.97)mm, respectively. The measurements at defecation phase were:(17.47±11.09)mm, (-7.01±10.52)mm, (-14.91±13.29)mm, (-20.05±14.18)mm , (-47.51±13.80)mm and (-46.87±14.90)mm, respectively. There is no statistically significant difference in distance of cervix, peritoneum, sigmoid colon, small intestine to PCL between rest and lift phase (t=1.32, 1.71, 1.70, 1.20, and P=0.19, 0.09, 0.09, 0.24, respectively). However, there are statistically significant difference in cervix, peritoneum, sigmoid colon, small intestine to PCL between rest and defecation (P<0.05) and between lift and defecation (P<0.05). The distance of anal-rectal junction, bladder neck to PCL showed statistically significant difference in rest, lift and defecation phases.

Distance of Cervix, peritoneum, sigmoid colon and small intestine to PCL shows no difference in rest and lift phases. Bladder neck, cervix, peritoneum, sigmoid colon and small intestine are above PCL in all three phases. Anal-rectal junction is below PCL no more than 2cm in defecation. This study can serve as normal reference for evaluation of pelvic organ prolapse.

Dynamic MRI defecography in normal female young volunteers can provide us with a diagnostic criteria to better understand and more appropriately treat for pelvic floor dysfunction.

Lian, Y, Zhou, Z, Liu, Z, Qiu, J, zhu, p, CAO, W, Dynamic MRI Defecography: Observation in Young Female Volunteers.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045798.html