Triphasic MRI of pelvic organ descent: sources of measurement error

Morren, Geert; Balasingam, Adrian; Wells, Joel; Hunter, Anne M.; Coates, Richard; Perry, Richard E.

doi:10.1016/j.ejrad.2004.05.009

Cited by 39 publications

(31 citation statements)

References 24 publications

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“…Only three papers regarding this subject have been published previously; compared to the present results, Morren et al 17 reported lower intra-observer concordance values, whereas Fauconnier et al 18 demonstrated excellent both intra-and interobserver concordance. As for Broekhuis et al, 11 in the present study an intra-observer concordance ranging from good to excellent for all measurements was observed.…”

Section: Discussioncontrasting

confidence: 38%

Static and dynamic evaluation of pelvic floor disorders with an open low-field tilting magnet

et al. 2013

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AIM: To assess the feasibility of magnetic resonance defaecography (MRD) in pelvic floor disorders using an open tilting magnet with a 0.25 T static field and to compare the results obtained from the same patient both in supine and orthostatic positions.MATERIALS AND METHODS: From May 2010 to November 2011, 49 symptomatic female subjects (mean age 43.5 years) were enrolled. All the patients underwent MRD in the supine and orthostatic positions using three-dimensional (3D) hybrid contrast-enhanced (HYCE) sequences and dynamic gradient echo (GE) T1-weighted sequences. All the patients underwent conventional defaecography (CD) to correlate both results. Two radiologists evaluated the examinations; inter and intra-observer concordance was measured. The results obtained in the two positions were compared between them and with CD.RESULTS: The comparison between CD and MRD found statistically significant differences in the evaluation of anterior and posterior rectocoele during defaecation in both positions and of rectal prolapse under the pubo-coccygeal line (PCL) during evacuation, only in the supine position (versus MRD orthostatic: rectal prolapse p < 0.0001; anterior rectocoele p < 0.001; posterior rectocoele p ¼ 0.008; versus CD: rectal prolapse p < 0.0001; anterior rectocoele p < 0.001; posterior rectocoele p ¼ 0.01). The value of intra-observer intra-class correlation coefficient (ICC) ranged from good to excellent; the interobserver ICC from moderate to excellent.CONCLUSION: MRD is feasible with an open low-field tilting magnet, and it is more accurate in the orthostatic position than in the supine position to evaluate pelvic floor disorders.

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Section: Discussioncontrasting

confidence: 38%

Static and dynamic evaluation of pelvic floor disorders with an open low-field tilting magnet

et al. 2013

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“…1. The pubococcygeal line was defined as a straight line between the inferior rim of the pubic bone and the last visible coccygeal joint [8,11], the H-line as a straight line between the inferior rim of the pubic bone and the posterior wall of the anal canal on the level of the impression of the puborectal sling [12], and the mid-pubic line as a line drawn through the longitudinal axis of the pubic bone, passing through its midequatorial point [9].…”

Section: Dynamic Mr Imaging Protocolmentioning

confidence: 99%

POP-Q, dynamic MR imaging, and perineal ultrasonography: do they agree in the quantification of female pelvic organ prolapse?

et al. 2009

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Introduction and hypothesis This study evaluates the agreement in prolapse staging between clinical examination, dynamic magnetic resonance (MR), imaging and perineal ultrasonography. Methods Anatomical landmarks in the anterior, central, and posterior compartment were assessed in relation to three reference lines on dynamic MR imaging and one reference line on dynamic ultrasonography. These measurements were compared to the according POP-Q measurements. Agreement between the three methods was analyzed with Spearman's rank correlation coefficient (r s ) and Bland and Altman plots. Results Correlations were good to moderate in the anterior compartment (r s range=0.49; 0.70) and moderate to poor (r s range = −0.03; 0.49) in the central and posterior compartment. This finding was independent of the staging method and reference lines used. Conclusion Pelvic organ prolapse staging with the use of POP-Q, dynamic MR imaging, and perineal ultrasonography only correlates in the anterior compartment.

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“…Intraobserver correlation of pelvic organ prolapse has been weak even in single-site studies (12). Moderate and moderate-to-good interobserver correlation of external anal sphincter atrophy on endoanal ( ϭ 0.53-0.56) and phased-array coil ( ϭ 0.55-0.80) MR imaging have been reported (15).…”

mentioning

confidence: 99%

“…Previously, a few small single-center series or retrospective studies have shown variable interobserver reliability in characterizing specific anatomic findings of anal sphincter and pelvic structures demonstrated by using MR imaging (9)(10)(11)(12)(13)(14). Intraobserver correlation of pelvic organ prolapse has been weak even in single-site studies (12).…”

mentioning

confidence: 99%

Reproducibility of Dynamic MR Imaging Pelvic Measurements: A Multi-institutional Study

Lockhart¹,

Fielding²,

Richter³

et al. 2008

Radiology

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Purpose:To assess the reproducibility of bone and soft-tissue pelvimetry measurements obtained from dynamic magnetic resonance (MR) imaging studies in primiparous women across multiple centers. Materials and Methods:All subjects prospectively gave consent for participation in this institutional review board-approved, HIPAA-compliant study. At six clinical sites, standardized dynamic pelvic 1.5-T multiplanar T2-weighted MR imaging was performed in three groups of primiparous women at 6 -12 months after birth: Group 1, vaginal delivery with anal sphincter tear (n ϭ 93); group 2, vaginal delivery without anal sphincter tear (n ϭ 79); and group 3, cesarean delivery without labor (n ϭ 26). After standardized central training, blinded readers at separate clinical sites and a blinded expert central reader measured nine bone and 10 soft-tissue pelvimetry parameters. Subsequently, three readers underwent additional standardized training, and reread 20 MR imaging studies. Measurement variability was assessed by using intraclass correlation for agreement between the clinical site and central readers. Acceptable agreement was defined as an intraclass correlation coefficient (ICC) of at least 0.7. Results:There was acceptable agreement (ICC range, Note: This copy is for your personal, non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, use the Radiology Reprints form at the end of this article. Pelvic floor symptoms are common in women after childbirth (1). Objective assessment of anatomic changes and structural pathologic indicators is an important adjunct in characterization of pelvic floor symptoms resulting from childbirth. Dynamic magnetic resonance (MR) imaging is used to assess pelvic organ prolapse (2-5); however, correlation of MR findings with physical examination and cystocolpoproctography results is variable (5-7). Defecography also has high interobserver variability (8). Measurement reproducibility is important to assess, whether in the research or the clinical setting, since it may affect management of patients with pelvic floor disorders.Previously, a few small single-center series or retrospective studies have shown variable interobserver reliability in characterizing specific anatomic findings of anal sphincter and pelvic structures demonstrated by using MR imaging (9-14). Intraobserver correlation of pelvic organ prolapse has been weak even in single-site studies (12). Moderate and moderate-to-good interobserver correlation of external anal sphincter atrophy on endoanal ( ϭ 0.53-0.56) and phased-array coil ( ϭ 0.55-0.80) MR imaging have been reported (15). Better interobserver correlation has been shown in other singlecenter studies (10,11). Beets-Tan et al (10) showed better interobserver correlation for the internal anal sphincter by using endoanal (intraclass correlation coefficient [ICC], 0.65) and phasedarray (ICC, 0.75) MR imaging. Keller et al (11) showed high interobserver correlation for bone measurements such as obstetric conjugate (ICC, 0.96...

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Triphasic MRI of pelvic organ descent: sources of measurement error

Cited by 39 publications

References 24 publications

Static and dynamic evaluation of pelvic floor disorders with an open low-field tilting magnet

Static and dynamic evaluation of pelvic floor disorders with an open low-field tilting magnet

POP-Q, dynamic MR imaging, and perineal ultrasonography: do they agree in the quantification of female pelvic organ prolapse?

Reproducibility of Dynamic MR Imaging Pelvic Measurements: A Multi-institutional Study

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