Learning Objectives: To assess the diagnostic role of MRI in the evaluation of female urinary incontinence and pelvic organ prolapse using dynamic MRI, as a baseline assessment and after surgery using “Patch and Plug” technique. Background: Dynamic MRI examination of pelvic prolapse is a good aid in the evaluation of both the type and degree of the female pelvic organ prolapse, representing a diagnostic confirmation of the clinical assessment. It is also useful to demonstrate prolapse has disappeared after surgery. MRI provides a complete evaluation of the pelvic organs by both static and dynamic imaging; it may also allow evaluation of the muscular and ligamentous structures of the pelvic floor. Procedure Details: 44 patients with genuine stress urinary incontinence and genital prolapse were investigated by standard and dynamic MRI, using a 1.5Tunit. Patients were placed in a supine position with the legs slightly flexed and abducted; 250ml of Gd-DTPA water solution were instilled into the bladder, 20ml of Gd water-gel solution was injected into the vagina and 50ml into the rectum. Dynamic images were obtained at rest and during Valsalva manoeuvre, using T1-FFE sequences on sagittal plane. Dynamic MRI was analyzed to determine the presence and extent of cystocele and vaginal vault prolapse. Conclusion: Dynamic MRI provided a good demonstration of genital prolapse during Valsalva manoeuvre in all cases; a good correlation with the clinical evaluation of both genital prolapse type and degree was found in the baseline assessment and after surgery.

Dynamic MRI in the assessment of female pelvic organ prolapse: Baseline and post-surgical evaluation

DI CESARE, Ernesto;MASCIOCCHI, CARLO
2006

Abstract

Learning Objectives: To assess the diagnostic role of MRI in the evaluation of female urinary incontinence and pelvic organ prolapse using dynamic MRI, as a baseline assessment and after surgery using “Patch and Plug” technique. Background: Dynamic MRI examination of pelvic prolapse is a good aid in the evaluation of both the type and degree of the female pelvic organ prolapse, representing a diagnostic confirmation of the clinical assessment. It is also useful to demonstrate prolapse has disappeared after surgery. MRI provides a complete evaluation of the pelvic organs by both static and dynamic imaging; it may also allow evaluation of the muscular and ligamentous structures of the pelvic floor. Procedure Details: 44 patients with genuine stress urinary incontinence and genital prolapse were investigated by standard and dynamic MRI, using a 1.5Tunit. Patients were placed in a supine position with the legs slightly flexed and abducted; 250ml of Gd-DTPA water solution were instilled into the bladder, 20ml of Gd water-gel solution was injected into the vagina and 50ml into the rectum. Dynamic images were obtained at rest and during Valsalva manoeuvre, using T1-FFE sequences on sagittal plane. Dynamic MRI was analyzed to determine the presence and extent of cystocele and vaginal vault prolapse. Conclusion: Dynamic MRI provided a good demonstration of genital prolapse during Valsalva manoeuvre in all cases; a good correlation with the clinical evaluation of both genital prolapse type and degree was found in the baseline assessment and after surgery.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11697/22375
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