The value of dynamic magnetic resonance imaging in interdisciplinary treatment of pelvic floor dysfunction

Attenberger, Ulrike; Morelli, John N.; Budjan, Johannes; Herold, Alexander; Kienle, Peter; Kleine, W.; Häcker, Axel; Baumann, Carol K.; Heinzelbecker, Julia; Schoenberg, Stefan O.; Michaely, Henrik J.

doi:10.1007/s00261-015-0476-y

Cited by 25 publications

(13 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…MRI is an important tool in the diagnostic work-up in patients with pelvic floor disorders, allowing for identification of occult abnormalities such as vaginal intussusceptions or enterocoeles. 27 However, limitations of the pelvic floor MRI include under-reporting of pelvic floor abnormalities in patients with poor rectal emptying 28 and a dearth of guidelines regarding imaging and reporting. MRI performed in the supine/sitting position gives variable results, 29 with increased detection of anterior and posterior abnormalities.…”

Section: Techniquementioning

confidence: 99%

Interobserver agreement of multicompartment ultrasound in the assessment of pelvic floor anatomy

Lone¹,

Sultan²,

Stankiewicz³

et al. 2016

BJR

View full text Add to dashboard Cite

Objective: To assess the interobserver agreement of pelvic floor anatomical measurements using multicompartment pelvic floor ultrasound. Methods: Females were recruited from the urogynaecology/gynaecology clinics between July and October 2009 and underwent multicompartment pelvic floor ultrasonography (PFUS) using twodimensional (2D) transperineal ultrasound (TPUS), high-frequency 2D/three-dimensional (3D) endovaginal ultrasound (EVUS) using a biplane probe with linear and transverse arrays and a 360°rotational 3D-EVUS. PFUS measurements were independently analysed by two clinicians. Results: 158 females had PFUS assessment. Good-toexcellent interobserver agreement was observed for bladder-symphysis distance at rest and valsalva, urethral thickness, urethral length, urethral volume, levator hiatus area and width, anteroposterior diameter and anorectal angle. Lins Correlation was used to calculate the interobserver agreement and Bland-Altman plots were created to demonstrate the agreement between the researchers. There was also a good-to-excellent agreement between the two clinicians for the assessment of pelvic organ prolapse (POP) in the anterior, middle and posterior compartment. Conclusion: Multicompartment PFUS is a reliable tool in the anatomical assessment of pelvic floor measurements and POP. Advances in knowledge: We found a good-to-excellent agreement between the two assessors in the assessment of pelvic floor measurements for all three pelvic floor compartments and suggest that multicompartment PFUS could be considered as a systematic integrated approach to assess the pelvic floor.

show abstract

Section: Techniquementioning

confidence: 99%

Interobserver agreement of multicompartment ultrasound in the assessment of pelvic floor anatomy

Lone¹,

Sultan²,

Stankiewicz³

et al. 2016

BJR

View full text Add to dashboard Cite

show abstract

“…Our findings suggest that DMRIPF is able to identify pelvic floor pathology in more than twice than physical examination alone. As notted by Attemberger et al in 2015, 18 DMRIPF evaluates the interaction between the three pelvic floor compartments and allows diagnosis of subclinical anatomical alterations that may influence changes to the therapeutic strategy. In our study, the displacement of abdominopelvic structures not perceived on physical examination, were diagnosed in 63.5 % of the patients.…”

Section: Discussionmentioning

confidence: 99%

Added value of dynamic magnetic resonance images in pelvic floor dysfunction

Rosato

Chwat

Lemme

et al. 2020

Journal of Coloproctology

View full text Add to dashboard Cite

Purpose Pelvic floor dysfunction has a high prevalence in the adult population. The Dynamic and Multiplanar Evaluation of the Pelvic Floor (DMRIPF) represents an ideal tool for multidisciplinary management. The purpose of this analysis is to evaluate the added value of the Dynamic and Multiplanar Evaluation of the Pelvic Floor in patients with suspected pelvic floor disorders. Methods Retrospective analysis of a consecutive series of patients who underwent a DMRIPF due to suspected pelvic floor disorders between April 2005 and July 2019. Results 359 patients were included. The average number of diagnoses achieved by physical examination was 1.2 vs. 2.5 by the Dynamic and Multiplanar Evaluation of the Pelvic Floor (p < 0.001). Physical examination found a single pathology in 80.8 % of cases. Anterior rectocele (AR) was the most frequent isolated diagnosis on physical examination (68 %). On the Dynamic and Multiplanar Evaluation of the Pelvic Floor, anterior rectocele was diagnosed as an isolated condition in 10.9 %. In 231 cases, anterior rectocele was associated with up to 5 other pelvic floor disorders. The number of individuals with associated pathologies of the posterior and anterior compartments tripled. It modified physical examination findings in 17 % of individuals and, in 63.5 %, allowed the identification of additional pelvic floor pathologies that were missed by physical examination. The Dynamic and Multiplanar Evaluation of the Pelvic Floor had greater added value in patients with anterior rectocele (59.6 % vs. 20.9 %; < 0.001). Female gender was also associated with a greater diagnostic yield (p < 0.001). Conclusion The Dynamic and Multiplanar Evaluation of the Pelvic Floor allows the detection of multi-compartment defects that could otherwise go undetected, or even alter the initial clinical diagnosis, representing an ideal tool for multidisciplinary approach of pelvic floor dislocations, allowing a comprehensive therapeutic planning.

show abstract

“…As such, MRI can assist in selection of the appropriate surgical approach. For example, in one study MRI changed management or the surgical approach relative to the clinical evaluation by an interdisciplinary team in nearly half of patients . In patients with fecal incontinence, the results of MRI lead to changes in the surgical approach 67% of surgical candidates …”

Section: Managementmentioning

confidence: 99%

“…Underestimation of pelvic organ prolapse may lead to an incorrect choice of treatment, contributing to high recurrence rates . Imaging has become an important complementary tool in the assessment of pelvic floor disorders, and dynamic pelvic floor magnetic resonance imaging (MRI), or MR defecography, has evolved as one of the essential imaging techniques . MRI can simultaneously noninvasively evaluate all pelvic floor compartments, and provide information about muscles and ligaments with great contrast resolution, without the use of ionizing radiation and with minimal patient discomfort .…”

mentioning

confidence: 99%

“…7,8 Imaging has become an important complementary tool in the assessment of pelvic floor disorders, and dynamic pelvic floor magnetic resonance imaging (MRI), or MR defecography, has evolved as one of the essential imaging techniques. [9][10][11] MRI can simultaneously noninvasively evaluate all pelvic floor compartments, and provide information about muscles and ligaments with great contrast resolution, without the use of ionizing radiation and with minimal patient discomfort. 12 While anterior and middle compartment causes of pelvic floor dysfunction can often be detected by physical exam, posterior compartment pathology such as enteroceles, peritoneoceles, and rectorectal intussusceptions are commonly not detected by physical exam but are well visualized by MRI.…”

mentioning

confidence: 99%

See 1 more Smart Citation