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. 2012 Nov;23(11):1547-54.
doi: 10.1007/s00192-012-1772-5. Epub 2012 Apr 25.

Dynamic magnetic resonance imaging to quantify pelvic organ prolapse: reliability of assessment and correlation with clinical findings and pelvic floor symptoms

Mariëlle M E Lakeman  1 , F M Zijta, J Peringa, A J Nederveen, J Stoker, J P W R Roovers
Affiliations

Dynamic magnetic resonance imaging to quantify pelvic organ prolapse: reliability of assessment and correlation with clinical findings and pelvic floor symptoms

Mariëlle M E Lakeman et al. Int Urogynecol J. 2012 Nov.

Abstract

Introduction and hypothesis: The aim of this study was to assess the interobserver agreement of magnetic resonance imaging (MRI)-based staging of pelvic organ prolapse (POP) and to quantify associations between MRI-based POP staging, findings at pelvic examination, and pelvic floor symptoms.

Methods: This was a cross-sectional study of ten symptomatic POP patients, ten symptomatic patients without POP, and ten nulliparous asymptomatic women. Three different observers performed MRI-based POP staging using the pubococcygeal line (PCL), midpubic line (MPL), perineal line, and H line as references.

Results: The interobserver agreement of MRI-based staging of the anterior and middle compartment was good to excellent. In symptomatic women without prolapse, MRI-based and pelvic-examination-based POP staging were poorly correlated. In none of the women were MRI-based POP Quantification (POP-Q) staging and pelvic floor symptoms strongly associated.

Conclusion: The interobserver agreement of MRI-based POP staging is excellent, but the added clinical value of such staging is questionable due to poor association with clinical findings and pelvic floor symptoms.

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Figures

Fig 1
Fig 1
a Static T2-weighted turbo spin echo (TSE) at rest for anatomical reference in midsagital plane through the pelvis of a 66-year old woman with pelvic organ prolapse (POP) symptoms. The uterus (Ut), bladder (B), pubic symphysis (PS), rectum (R), puborectal muscle (PR), and perineal body (PB) are shown. b Dynamic midsagital half-Fourier-acquisition single-shot turbo spin-echo (HASTE) sequence during straining in the same patient. Reference lines: pubococcygeal line (PCL), H-line, perineal line, midpubic line (MPL), and M-line
See this image and copyright information in PMC

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