Review the magnetic resonance imaging (MRI) findings of pelvic floor dysfunction (PFD)
Provide correlation between MRI and clinical findings in patients with PFD
Establish the advantages of a structured MRI evaluation in the assessment of patients with suspected PFD
Pelvic floor dysfunction (PFD) is a wide spectrum of functional conditions that result from pelvic floor’s supporting structures abnormalities.
These conditions are associated with great impairment of quality of life,
as they can cause:
Stress urinary incontinence
Difficulty in voiding
Pelvic organ prolapse
Sense of pressure
Female sex and ageing are considered the most important risk factors for PFD,
which affects approximately half of women older than 50 years,
being amajor cause of loss of quality of life...
Findings and procedure details
Recommended MRI Imaging Protocols
Staticand dynamic sequences should be acquired; T2-weighted images (T2WI) are recommendedfor both,
due to its greater anatomic detail.
( Fig. 1).
T1WI should complement the examination,
whenever a pelvic lesion is detected.
Static images→ Detection and classification of structural abnormalities
→ Pelvic floor anatomy
→ Defects of the supporting structures
→ Anal sphincter complex
Dynamic images (during squeezing,
straining and defecation) → functional abnormalities that are assessed by metric measurements of the three compartments
→ Pelvic organ mobility
Clinical evaluation of patients with PFD is often limited,
both in grading pelvic organ prolapse and identifying the pathologic mechanisms underlying the clinical findings.
identification of the underlying pathologic defects allows specific therapeutic approach,
which probably results in better outcomes,
sincesurgical repair of only one compartment may result in an increasing of dysfunctionof the other also damaged compartments.
MRI frequently allows an accurate anatomic and functional evaluation of the three pelvic compartments,
allowing the correct identification of the compartments involved,
sometimes not so...
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García del Salto,
MR Imaging–based Assessment of the...