Role of structured reporting in MRI evaluation of the pelvic floor dysfunction

Congress:

ECR 2020

Poster Number:

C-13223

Type:

Scientific Exhibit

Keywords:

Performed at one institution, Observational, Not applicable, Pelvic floor dysfunction, Structured reporting, Defecography, MR, Pelvis, Genital / Reproductive system female, GI Tract

Authors:

A. Molinari¹, G. Buonomenna², A. Romani³, D. Schettini³, N. GANDOLFO³; ¹Sanremo/IT, ²Avellino/IT, ³Genova/IT

DOI:

10.26044/ecr2020/C-13223

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-13223

Fig. 2: Schematic shows the three functional anatomic compartments of the female...

Fig. 3: PCL is drawn from the inferior border of the pubic symphysis to the last...

Fig. 1

Purpose

This study was done to establish the advantages of the structured report in the assessment of patients with suspected pelvic floor dysfunction (PFD) with dynamic MRI. The article describes: Normal pelvic floor anatomy’s landmarks and the most common disorders. Our institute experience in image analysis, measurements, grading and MRI report following a proposal of structured template.

Methods and materials

Background: Pelvic floor weakness refers to a spectrum of functional disorders caused by impairment of the ligaments, fasciae, and muscles that support the pelvic organs. Such disorders include urinary and fecal incontinence, obstructed defecation and pelvic organ prolapse. The most significant risk factors are ageing and female sex. Pelvic organ prolapse is the abnormal descent of a pelvic organ through the hiatus beneath it. This condition may affect the bladder (cystocele), vagina (vaginal prolapse), uterus (uterine prolapse), mesenteric fat (peritoneocele), small intestine (enterocele) or sigmoid...

Results

Dynamicrest sequences identified the following abnormalities: 23 cases of single compartment pathology: 2 mild cystoceles and 21 posterior compartment descent (PCD) -19 mild 2 and moderate - Dynamic evacuation sequences revealed 23 mild, 4 moderate and 1 severe cystoceles (n. 28); 9 mild and 4 moderate middle compartment prolapse (n. 13); 6 mild, 16 moderate and 16 severe PCD (n. 38). 32/38 showed anterior rectocele and 6/38 didn’t show remarkable rectocele. PCDs showed the following variations between rest and evacuation phase: 20 cases with no...

Conclusion

Radiologists can perform MRI as the best modality to evaluate pelvic floor functional abnormalities. Our report confirms that theevacuationphase is the most sensitive and the in the identification of pelvic organ prolapses. Notably we observed that posterior compartment descent is the most common disorder. We highlighted the increasing severity between rest and evacuation sequence and the association with other compartments abnormalities. The usual presentation with multi compartments prolapse, such as both cystocele and rectocele is related to the physiological connection among the various support structures...

Personal information and conflict of interest

A. Molinari; Sanremo/IT - nothing to disclose G. Buonomenna; Avellino/IT - nothing to disclose A. Romani; Genoa/IT - nothing to disclose D. Schettini; Genoa/IT - nothing to disclose N. Gandolfo; Genoa/IT - nothing to disclose

References

1. Bitti GT, Argiolas GM, Ballicu N et al. Pelvic Floor Failure: MR Imaging Evaluation of anatomic and functional abnormalities. Radiographics (2014); 34:429-448. 2. Garcia dSL De Miguel CJ, Felipe Aguilera dHL. MR Imaging–based Assessment of the Female Pelvic Floor. RadioGraphics 2014; 34:1417–1439. doi: 10.1148/rg.345140137 3. Romani A, Martino L, Martini C et al.Approccio all’anatomia e alle principali disfunzioni del pavimento pelvico femminilie mediante imaging RM ed ETG. Giornale Italiano di Radiologia Medica (2015) 2: 904-910 doi: 10.17376/girm_2-6-11122015-2 4. El Sayed RF, Alt DC, Maccioni...