Purpose
The purpose of study was to compare dynamic MR imaging of the pelvic floor performed on open-magnet with the patient in sitting position (UP-MR) against closed-magnet with the patient in supine position (SE-MR).
Methods and Materials
Eighteen patients with clinical evidence of pelvic floor descent were enrolled (mean age,
45 years).
In accordance with the guidelines of our institute,
written informed consent was asked at all patients.
Imaging Technique
Patients first underwent SE-MR in a 1.5-T closed magnet (Magnetom Symphony,Siemens,Germany).
All patients were imaged supine (recumbent).
To ensure an adequate bladder filling,
all patients were invited to drink 500–700 ml of water 10–15 min before the examination.
The rectum and the vagina were filled with 200 mL and about 25–30 mL...
Results
Evaluation of all three compartments of the pelvic floor was possible in both sitting and supine positions for all patients.
Enterocele was diagnosed at SE-MR in 16 pazients.
At UP-MR images we have a reduction in image quality but it allows the visualization of 2 elytrocele missed with SE-MR. Rectocele was visualized in all patients at both sitting and supine position.
Rectal intussusception was seen in 8 patients in UP-MR and in 6 patients at SE-MR images.
The association of different pelvic floor disorders is...
Conclusion
SE-MR has been hampered by the closed architecture of conventional MR systems,
limiting the patient position to the horizontal plane.
With the advent of open-configuration MR systems,
MR defecography with the patient in the sitting position has become possible (1,2,3).
The use of this technique is limited by worldwide availability.
According with previous reports (4,5),
our results show that SE-MR resulted in an underestimation of the severity of all disorders.
In addition relevant abnormalities that was seen at UP-MR images (see fig.
1,
fig 2)...
References
1)Dynamic MRI defecography vs.
entero-colpo-cysto-defecography in the evaluation of midline pelvic floor hernias in female pelvic floor disorders.
Cappabianca S,
Reginelli A,
Iacobellis F,
Granata V,
Urciuoli L,
Alabiso ME,
Di Grezia G,
Marano I,
Gatta G,
Grassi R.Int J Colorectal Dis.,
2011; 26(9):1191-6.
2)MRI of pelvic floor dysfunction: review.
Law YM,
Fielding JR.
AJR Am J Roentgenol.
2008 ;191(6 Suppl):S45-53.
3)MR imaging of pelvic floor continence mechanisms in the supine and sitting positions.
Fielding JR,
Griffiths DJ,
Versi E,
Mulkern RV,
Lee ML,Jolesz FA....