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Use of Dynamic MRI of the Pelvic Floor in the Assessment of Anterior Compartment Disorders

  • New Imaging Techniques (S Rais-Bahrami and K Porter, Section Editors)
  • Published:
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Abstract

Purpose of Review

Approximately 25% of women in the USA suffer from pelvic floor disorders. Disorders of the anterior compartment of the pelvic floor, in particular, can cause symptoms such as incomplete urinary voiding, urinary incontinence, pelvic organ prolapse, dyspareunia, and pelvic pain, potentially negatively impacting a woman’s quality of life. In some clinical situations, clinical exam alone may be insufficient, especially when patient’s symptoms are in excess of their pelvic exam findings. In many of these patients, dynamic magnetic resonance imaging (dMRI) of the pelvic floor can be a valuable imaging tool allowing for comprehensive assessment of the entire pelvic anatomy and its function.

Recent Findings

Traditionally, evaluation of the anterior compartment has been primarily through clinical examination with occasional use of urodynamic testing and ultrasound. In recent years, dMRI has continued to gain popularity due to its improved imaging quality, reproducibility, and ability to display the entire pelvic floor. Emerging evidence has also shown utility of dMRI in the postoperative setting. In spite of advances, there remains an ongoing discussion in contemporary literature regarding the accuracy of dMRI and its correlation with clinical examination and with patient symptoms.

Summary

Dynamic pelvic MRI is a helpful adjunct to physical examination and urodynamic testing, particularly when a patient’s symptoms are in excess of the physical examination findings. Evaluation with dMRI can guide preoperative and postoperative surgical management in many patients, especially in the setting of multicompartmental disorders. This review will summarize relevant pelvic floor anatomy and discuss the clinical application, imaging technique, imaging interpretation, and limitations of dMRI.

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Authors and Affiliations

  1. Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 601 N. Caroline Street, JHOC 3140C, Baltimore, MD, 21287, USA

    Ayushi P. Gupta, My-Linh Nguyen & Katarzyna J. Macura

  2. Department of Radiology and Imaging Sciences, Division of Abdominal Imaging, Emory University School of Medicine, 1365-A Clifton Road NE, Suite AT-627, Atlanta, GA, 30322, USA

    Ayushi P. Gupta

  3. Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Johns Hopkins University School of Medicine, 301 Building, Suite 3200, 4940 Eastern Avenue, Baltimore, MD, 21224, USA

    Prerna Raj Pandya

  4. Department of Imaging Services, Mid-Atlantic Permanente Medical Group, 2101 E. Jefferson Street, Rockville, MD, 20852, USA

    My-Linh Nguyen

  5. Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Sinai Hospital of Baltimore, 2411 West Belvedere Avenue, Baltimore, MD, 21215, USA

    Tola Fashokun

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  1. Ayushi P. Gupta
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Correspondence to Ayushi P. Gupta.

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Ayushi Gupta, Prerna Raj Pandya, My-Linh Nguyen, Tola Fashokun, and Katarzyna J. Macura each declare no potential conflicts of interest.

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This article is part of the Topical Collection on New Imaging Techniques

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Gupta, A.P., Pandya, P.R., Nguyen, ML. et al. Use of Dynamic MRI of the Pelvic Floor in the Assessment of Anterior Compartment Disorders. Curr Urol Rep 19, 112 (2018). https://doi.org/10.1007/s11934-018-0862-4

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  • DOI: https://doi.org/10.1007/s11934-018-0862-4

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