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Dynamic Magnetic Resonance Imaging and pelvic floor disorders: how and when?

Eur J Obstet Gynecol Reprod Biol. 2014 Oct;181C:259-266. doi: 10.1016/j.ejogrb.2014.07.025. Epub 2014 Jul 30. Review.

Pizzoferrato AC1, Nyangoh Timoh K2, Fritel X3, Zareski E2, Bader G2, Fauconnier A4.
Author information 1Department of Gynaecology and Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France; Research Unit EA7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, Université Versailles St-Quentin, Montigny-le-Bretonneux, France. Electronic address: ac_pizzoferrato@yahoo.com.2Department of Gynaecology and Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France.3Poitiers University, INSERM CIC1402, University Hospital of Poitiers, Poitiers, France.4Department of Gynaecology and Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France; Research Unit EA7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, Université Versailles St-Quentin, Montigny-le-Bretonneux, France.
Eur J Obstet Gynecol Reprod Biol
ABSTRACT
AbstractPelvic Floor Disorders (PFD) are a major public health problem in the world and decrease seriously the patient’s quality of life. In case of recurrence after surgery or complex prolapse, imaging techniques can be used. Dynamic MRI, introduced in the early 1990s, offers information of the four compartments of the pelvis with a high resolution and a direct visualization of muscles and fascias in multiple planes. But for a practical use, such an expensive exam should be well correlated to symptoms and clinical examination or change surgical approach. The aim of our review was to precise the evidence regarding techniques, and indication of dynamic MRI in the assessment of pelvic floor disorders in daily practice. The first part is a review of available studies on methods of carrying out the dynamic MRI. The second part consists on the comparison of dynamic MRI to other assessment methods in case of pelvic floor disorders. Results emphasize the lack of strong level studies about the interest of dynamic MRI in the diagnosis and surgical management of pelvic organ prolapse. Although dynamic MRI appears highly reproducible between examiners, especially for the anterior compartment, its correlation with the degree of prolapse or the symptoms appears low. The most interesting field of application seems the detection of levator ani (LA) avulsion with a higher risk of prolapse and recidive in case of LA defects. More prospective, randomized, comparative studies have to be done.Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Full Text Source: Elsevier Science
PMID:25212114 | http://www.ncbi.nlm.nih.gov/pubmed/25212114

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