Dynamic magnetic resonance imaging (MRI) using a single shot fast spin‐echo technique was evaluated as a noninvasive alternative to cystourethography or colpocystorectography in patients with pelvic organ prolapse and/or urinary incontinence. Thirty‐two patients were included in this prospective study. Colpocystorectography was performed in 10 patients who previously had undergone hysterectomy and in 2 patients without history of hysterectomy with clinical suspicion of rectoceles. Bead‐chain cystourethrography was performed in 20 patients without hysterectomy. For dynamic MRI, a single‐slice half‐Fourier RARE sequence (imaging time 2 seconds) was used to depict the pelvic organs at different levels of pelvic strain. The results obtained with dynamic MRI were correlated with the x‐ray findings. All 17 cystoceles, 10 rectoceles, 2 enteroceles, and 7 vaginal prolapses could be demonstrated on MRI. Diagnostic information gained from these images was equivalent to that obtained with colpocystorectography and superior to that obtained with cystourethrography; with the latter, important findings were missed (four rectoceles). We conclude that dynamic MRI of the pelvic floor with a half‐Fourier RARE sequence can reliably detect descents of all three pelvic compartments, that it requires no contrast agent, and that no radiation exposure is involved.J. Magn. Reson. Imaging 1999;9:378–383. © 1999 Wiley‐Liss, Inc.

Dynamic MRI is helpful in the evaluation of persistent patient complaints after surgery for pelvic organ prolapse and detects more defects than physical examination does.

Measurement data on dynamic MRI for the bladder neck position and the extension of cystocele at maximal pelvic strain are comparable with lateral cystourethrogram data.