MR rectography evaluation of rectoceles with oral gadopentetate dimeglumine and polyethylene glycol solution

Abstract

The combination of oral contrast and polyethylene glycol solution improves the diagnostic value of MR rectography and is particularly useful when noncontrast examinations are inconclusive.

A systematic review of clinical studies on dynamic magnetic resonance imaging of pelvic organ prolapse: the use of reference lines and anatomical landmarks

“…Thus, a total of 509 studies were checked for eligibility, of which 432 studies could be excluded on the basis of title and abstract. The remaining 77 studies were read by paper, but only ten studies [24][25][26][27][28][29][30][31][32][33], published between 1993 and 2007, fulfilled the inclusion criteria. Sixty-one studies were excluded because they did not conform to our inclusion criteria: no report on a reference line used to stage the prolapse on dynamic MR imaging (n studies=1), no standardized method of gynecological prolapse staging (pre-or intraoperative; n studies=23), and no comparison of the dynamic MR imaging and gynecological prolapse staging (n studies = 7).…”

“…Pelvic organ prolapse was staged using the POP-Q and Baden-Walker system, except for Agildere et al [24] who have classified rectal protrusion into the vagina as absent, small, moderate, or large, according to a system as described by Delemarre et al [35]. Six out of the ten studies included in the present review have included symptom-free or healthy women [26-29, 31, 32].…”

“…The bladder, and/or vagina, and/or rectum was/were opacified in three studies [25,29,33], whereas the other seven did not use opacification [24,[26][27][28][30][31][32], or even emptied the bladder [24,26,31]. Agildere et al [24] used an oral contrast agent (gadopentetatedimeglumine or gadopentetatedimeglumine plus polyethylene glycol).…”

“…Patients were asked to defecate during imaging in two studies [24,31]. In three studies, patients were instructed to perform an increasing straining maneuver [25,27,30].…”

“…Table 4 provides an overview of the results on the comparison of clinical prolapse staging and dynamic MR imaging staging, as well as the author's conclusions in this respect. For all studies, this comparison concerned the primary outcome measure of the study, except for Agildere et al [24]. Reliability of MR imaging findings using the mid-pubic line versus clinical findings measured by Cohen's kappa was poor to fair.…”