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Clin Radiol. 2014 Feb;69(2):e71-7. doi: 10.1016/j.crad.2013.09.015. Epub 2013 Nov 26.

Prevalence of pelvic organ prolapse detected at dynamic MRI in women without history of pelvic floor dysfunction: comparison of two reference lines.

Author information

1
Department of Radiology, NYU Langone Medical Center, New York, NY, USA. Electronic address: Andrew.Rosenkrantz@nyumc.org.
2
Department of Radiology, NYU Langone Medical Center, New York, NY, USA.

Abstract

AIM:

To retrospectively evaluate the prevalence of pelvic organ prolapse as an incidental finding on dynamic magnetic resonance imaging (MRI) using two different references lines.

MATERIALS AND METHODS:

Sixty women with symptoms unrelated to pelvic floor dysfunction who underwent MRI including a dynamic sagittal true fast imaging with steady-state free precession (TrueFISP) sequence during straining were identified. Two radiologists in consensus used the pubococcygeal line (PCL) and mid-pubic line (MPL) to diagnose and grade prolapse in all three pelvic compartments.

RESULTS:

Cystocele was absent, mild, moderate, and severe in 88% (53/60), 7% (4/60), 5% (3/60), and 0% (0/60) of patients, respectively, using PCL, versus 78% (47/60), 13% (8/60), 5% (3/60), and 3% (2/60) of patients, respectively, using MPL. Vaginal prolapse was absent, mild, moderate, and severe in 95% (57/60), 5% (3/60), 0% (0/60), and 0% (0/60) of patients, respectively, using PCL, versus 80% (48/60), 17% (10/60), 3% (2/60), and 0% (0/60) of patients, respectively, using MPL. Rectal descent was absent, mild, moderate, and severe in 63% (38/60), 10% (6/60), 23% (14/60), and 3% (2/60) of patients, respectively, using PCL, versus 43% (26/60), 27% (16/60), 27% (16/60), and 3% (2/60) of patients, respectively, using MPL. No enterocele, peritoneocele, or muscular defect was identified. Two percent (1/60) of patients had mild rectocele, 8% (5/60) had abnormal vesico-urethral angle, and 25% (15/60) had abnormal levator plate angle.

CONCLUSION:

In asymptomatic women, dynamic MRI identified the greatest degrees of prolapse in the posterior compartment. The MPL consistently yielded greater frequency of prolapse than the PCL. Findings of pelvic organ prolapse may be observed in asymptomatic patients and are of uncertain significance, requiring correlation with clinical and physical examination findings.

PMID:
24290773
DOI:
10.1016/j.crad.2013.09.015
[Indexed for MEDLINE]
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