Magnetic resonance imaging of pelvic floor relaxation: Dynamic analysis and evaluation of patients before and after surgical repair

M. A. Goodrich, M. J. Webb, Bernard Francis King, A. E H Bampton, Norbert G Campeau, Stephen J Riederer

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124 Citations (Scopus)

Abstract

Objective: To evaluate structures involved in pelvic support using conventional and snapshot magnetic resonance imaging (MRI). Methods: We used conventional spin-echo MRI and dynamic snapshot GRASS MRI at various levels of the Valsalva maneuver to describe and quantitate the anatomy of pelvic floor relaxation and to assess anatomical changes produced by surgical repair. Ten female volunteers were evaluated to define normal anatomy and reference measurements. Five women with pelvic floor relaxation were evaluated before and after surgical repair. Results: Static and dynamic MRI were more sensitive than clinical pelvic examination in assessinig and grading pelvic floor relaxation. Quantitative results showed widening of the levator hiatus and more vertical lie of the levator plate postoperatively. Descent of the pelvic organs on maximal straining postoperatively was the same as that in normal volunteers. The posterior urethrovesical angle on MRI was more than 110° in 14 of 15 continent subjects. Conclusions: Magnetic resonance imaging may be valuable in analyzing and assessing pelvic floor relaxation and in understanding anatomical changes occurring before and after surgical repair. The increased sensitivity of MRI in grading prolapse may make it useful in evaluating women with symptoms of pelvic floor relaxation but who have negative findings on clinical examination.

Original languageEnglish (US)
Pages (from-to)883-891
Number of pages9
JournalObstetrics and Gynecology
Volume82
Issue number6
StatePublished - 1993

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Pelvic Floor
Magnetic Resonance Imaging
Anatomy
Valsalva Maneuver
Gynecological Examination
Prolapse
Volunteers
Healthy Volunteers

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

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title = "Magnetic resonance imaging of pelvic floor relaxation: Dynamic analysis and evaluation of patients before and after surgical repair",
abstract = "Objective: To evaluate structures involved in pelvic support using conventional and snapshot magnetic resonance imaging (MRI). Methods: We used conventional spin-echo MRI and dynamic snapshot GRASS MRI at various levels of the Valsalva maneuver to describe and quantitate the anatomy of pelvic floor relaxation and to assess anatomical changes produced by surgical repair. Ten female volunteers were evaluated to define normal anatomy and reference measurements. Five women with pelvic floor relaxation were evaluated before and after surgical repair. Results: Static and dynamic MRI were more sensitive than clinical pelvic examination in assessinig and grading pelvic floor relaxation. Quantitative results showed widening of the levator hiatus and more vertical lie of the levator plate postoperatively. Descent of the pelvic organs on maximal straining postoperatively was the same as that in normal volunteers. The posterior urethrovesical angle on MRI was more than 110° in 14 of 15 continent subjects. Conclusions: Magnetic resonance imaging may be valuable in analyzing and assessing pelvic floor relaxation and in understanding anatomical changes occurring before and after surgical repair. The increased sensitivity of MRI in grading prolapse may make it useful in evaluating women with symptoms of pelvic floor relaxation but who have negative findings on clinical examination.",
author = "Goodrich, {M. A.} and Webb, {M. J.} and King, {Bernard Francis} and Bampton, {A. E H} and Campeau, {Norbert G} and Riederer, {Stephen J}",
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T1 - Magnetic resonance imaging of pelvic floor relaxation

T2 - Dynamic analysis and evaluation of patients before and after surgical repair

AU - Goodrich, M. A.

AU - Webb, M. J.

AU - King, Bernard Francis

AU - Bampton, A. E H

AU - Campeau, Norbert G

AU - Riederer, Stephen J

PY - 1993

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N2 - Objective: To evaluate structures involved in pelvic support using conventional and snapshot magnetic resonance imaging (MRI). Methods: We used conventional spin-echo MRI and dynamic snapshot GRASS MRI at various levels of the Valsalva maneuver to describe and quantitate the anatomy of pelvic floor relaxation and to assess anatomical changes produced by surgical repair. Ten female volunteers were evaluated to define normal anatomy and reference measurements. Five women with pelvic floor relaxation were evaluated before and after surgical repair. Results: Static and dynamic MRI were more sensitive than clinical pelvic examination in assessinig and grading pelvic floor relaxation. Quantitative results showed widening of the levator hiatus and more vertical lie of the levator plate postoperatively. Descent of the pelvic organs on maximal straining postoperatively was the same as that in normal volunteers. The posterior urethrovesical angle on MRI was more than 110° in 14 of 15 continent subjects. Conclusions: Magnetic resonance imaging may be valuable in analyzing and assessing pelvic floor relaxation and in understanding anatomical changes occurring before and after surgical repair. The increased sensitivity of MRI in grading prolapse may make it useful in evaluating women with symptoms of pelvic floor relaxation but who have negative findings on clinical examination.

AB - Objective: To evaluate structures involved in pelvic support using conventional and snapshot magnetic resonance imaging (MRI). Methods: We used conventional spin-echo MRI and dynamic snapshot GRASS MRI at various levels of the Valsalva maneuver to describe and quantitate the anatomy of pelvic floor relaxation and to assess anatomical changes produced by surgical repair. Ten female volunteers were evaluated to define normal anatomy and reference measurements. Five women with pelvic floor relaxation were evaluated before and after surgical repair. Results: Static and dynamic MRI were more sensitive than clinical pelvic examination in assessinig and grading pelvic floor relaxation. Quantitative results showed widening of the levator hiatus and more vertical lie of the levator plate postoperatively. Descent of the pelvic organs on maximal straining postoperatively was the same as that in normal volunteers. The posterior urethrovesical angle on MRI was more than 110° in 14 of 15 continent subjects. Conclusions: Magnetic resonance imaging may be valuable in analyzing and assessing pelvic floor relaxation and in understanding anatomical changes occurring before and after surgical repair. The increased sensitivity of MRI in grading prolapse may make it useful in evaluating women with symptoms of pelvic floor relaxation but who have negative findings on clinical examination.

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