Pelvic Floor Dysfunction: Assessment with Combined Analysis of Static and Dynamic MR Imaging Findings

Sayed, El; Mashed, Sahar El; Farag, Ahmed; Morsy, Mohamed M.; Azim, Mohamed Salah Abdel

doi:10.1148/radiol.2482070974

Cited by 63 publications

(47 citation statements)

References 33 publications

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“…A lower magnitude of displacement is also attributed to stronger fascial attachments [36]. An MRI study confirmed fascial anatomical defects in SUI women [22]. Barbic et al [31] found that greater compliance of BN support with a delay in muscle activation and early onset of PFM activation was interpreted as a pretension of endopelvic fascia and vaginal wall tissues.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have been included in spite of the existence of exclusion criteria such as prolapse [21][22][23], being male [24], anal incontinence [22] and urge incontinence [25,26] if the data had been reported separately between the subject groups. In that case the data of only continent and SUI patients were extracted according to the a priori established criteria.…”

Section: Eligibility Criteria and Search Strategymentioning

confidence: 99%

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Pelvic floor muscle displacement during voluntary and involuntary activation in continent and incontinent women: a systematic review

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Section: Eligibility Criteria and Search Strategymentioning

confidence: 99%

Pelvic floor muscle displacement during voluntary and involuntary activation in continent and incontinent women: a systematic review

et al. 2015

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“…Sonography has developed to include a three-dimensional dynamic anorectal ultrasonography technique (dynamic 3-DAUS) using a 360°t ransducer, automatic scanning, and high frequencies for high-resolution images to evaluate evacuation disorders affecting the posterior compartment (rectocele, intussusception, and anismus) and the middle compartment (grade III sigmoidocele/enterocele) with the advantage of being minimally invasive and radiation free. However, the learning curve is significant and the field of view limited to the posterior compartment preventing the study of the remaining compartments [24][25][26][27][28][29][30].…”

Section: How To Study and Characterize Pelvic Floor Disordersmentioning

confidence: 99%

“…Technical advances allowing acquisition of dynamic rapid MRI sequences have been applied to pelvic floor imaging which can provide objective information about disorders of the different compartments of the pelvis without ionizing radiation exposure [27][28][29][30][31]. However, because most of these exams are made supine which has less gravitational influence than sitting, underestimation of pelvic floor descent, intussusceptions, and even lack of detection of enteroceles or sigmoidoceles can occur [32,33].…”

Section: How To Study and Characterize Pelvic Floor Disordersmentioning

confidence: 99%

Pelvic floor disorders: what’s the best test?

Silva

Maglinte

2013

Abdom Imaging

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Pelvic floor dysfunctions represent a common health problem affecting particularly post-menopausal women impacting significantly the quality of life. A large number of these patients suffer for many years without proper treatment often due to the lack of objective findings necessary to plan proper treatment. Because abnormalities of the different pelvic compartments are frequently associated, thorough diagnostic characterization of how many compartments are affected is paramount in order to plan the management approach that can include a multidisciplinary surgical approach. This pictorial essay will review the different imaging methods used for the characterization of these disorders, how to do them and its rationale providing a clinically understandable interpretation with clinical correlates and a correlation between fluoroscopic and MR defecography in order to illustrate the strengths and shortcomings of each. The need to use a standardized, reliable, and clinically understandable method of quantification has become more obvious in the last decades with the increasing rate of scientific and professional interchanges. A review of the grading systems used to convey the imaging findings also highlights the importance of using a standardized tool for comparing and communicating clinical findings understandable to referring physicians with proven inter-observer and intra-observer agreement of the examinations.

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“…Beyond this, magnetic resonance imaging (MRI) and functional dynamic (cine-or real-time) MRI in particular have been employed to assess functional pelvic floor disorders in the female pelvis and have gained importance as a valuable diagnostic adjunct in the workup of urinary dysfunctions [2,3] . Few preliminary data have been presented using real-time MRI to describe the postoperative configuration of neobladder [4] .…”

Section: Introductionmentioning

confidence: 99%

Real-Time MRI of Continent and Stress Incontinent Male Patients after Orthotopic Ileal Neobladder

et al. 2011

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Introduction: The aim of this study was to correlate anatomic differences with continence status in male patients after cystoprostatectomy and ileal neobladder using real-time magnetic resonance imaging. Patients and Methods: Anatomic differences of 14 male patients (7 daytime continent and 7 stress incontinent) with ileal neobladder were determined by measuring the orthogonal distance of the bladder neck to the pubococcygeal line (PCL) to correlate anatomic differences with continence status. Results: The median distance of the bladder neck to PCL was +5.4 mm in continent patients before voiding whereas in incontinent patients it was +2 mm (p = 0.012). During the Valsalva maneuver, the median distance in continent patients was +4 and in incontinent patients –3 mm (p = 0.003). At the end of micturition, the median distance was +2.3 mm in continent patients and –12 mm in incontinent patients (p = 0.002). Conclusions: The bladder neck in incontinent patients showed more pronounced mobility in relation to the PCL during micturition and the Valsalva maneuver as compared to continent patients. In addition, the ileal neobladder was positioned significantly lower in the pelvis of incontinent patients. These preliminary results suggest that a stable bladder neck may be an important factor to reach full continence in patients with ileal neobladder.

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Pelvic Floor Dysfunction: Assessment with Combined Analysis of Static and Dynamic MR Imaging Findings

Abstract: Combined analysis of static and dynamic MR images of patients with pelvic floor dysfunction allowed identification of certain structural abnormalities with specific dysfunctions.

Cited by 63 publications

References 33 publications

Pelvic floor muscle displacement during voluntary and involuntary activation in continent and incontinent women: a systematic review

Pelvic floor muscle displacement during voluntary and involuntary activation in continent and incontinent women: a systematic review

Pelvic floor disorders: what’s the best test?

Real-Time MRI of Continent and Stress Incontinent Male Patients after Orthotopic Ileal Neobladder

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