Practical guide to dynamic pelvic floor MRI

Kobi, Mariya; Flusberg, Milana; Paroder, Viktoriya; Chernyak, Victoria

doi:10.1002/jmri.25998

Cited by 35 publications

(21 citation statements)

References 82 publications

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“…For instance, Garcia del Salto et al ., Bitti et al . and Kobi et al . proposed using the pubococcygeal line, which is drawn from the inferior border of the pubic symphysis to the last coccygeal joint, and midpubic line, which is drawn caudad along the long axis of the pubic symphysis …”

Section: Discussionmentioning

confidence: 99%

“…Some diagnostic imaging markers for application to POP have been proposed. For instance, Garcia del Salto et al, 8 Bitti et al 9 and Kobi et al 10 proposed using the pubococcygeal line, which is drawn from the inferior border of the pubic symphysis to the last coccygeal joint, [11][12][13] and midpubic line, which is drawn caudad along the long axis of the pubic symphysis. [14][15][16] The European Society of Urogenital Radiology and the European Society of Gastrointestinal and Abdominal Radiology pelvic floor working group also proposed recommendation of many standard rules about MRI for the diagnosis and grading of POP.…”

Section: Discussionmentioning

confidence: 99%

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Quantitative evaluation of age‐related changes to pelvic floor muscles in magnetic resonance images from 369 patients

Komemushi

Morimoto³

et al. 2019

Geriatrics Gerontology Int

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Aim This study aimed to establish and validate a quantitative evaluation method for pelvic floor muscles using magnetic resonance images (MRI) and to examine the morphological change of pelvic floor muscles with aging. Methods Data from 369 consecutive patients (163 men, 206 women; median age 58 years; range 17–92 years) who underwent coronal T2‐weighted pelvic MRI at Osaka General Hospital between January 2016 and December 2016 were retrospectively examined. MRI of the levator ani muscle was evaluated. The MRI image blinded the patient information and was evaluated by a radiology specialist with 22 years of experience. In coronal T2‐weighted MRI of the pelvis, the levator ani muscle was evaluated using the slice; it showed the most upward and downward convexity. We measured the thickness of the levator ani muscle, and the distance at the most convex part from a straight line connecting the origin and insertion of the levator ani muscle on both the left and right sides. Upward and downward convexity was recorded in positive and negative values, respectively. Results The levator ani muscle was able to be evaluated quantitatively in all cases. Both men and women showed thinning (men: mean 3.316 mm, r = −0.388, P < 0.0001; women: mean 3.947 mm, r = −0.359, P < 0.0001) and concavity (men: mean 1.412 mm, r = −0.362, P < 0.0001; women: mean 4.979 mm, r = −0.630, P < 0.0001) of the levator ani muscle with aging. Conclusions A quantitative evaluation method for pelvic floor muscles using MRI was established. Aging was associated with morphological changes in the pelvic floor muscles in both men and women. Geriatr Gerontol Int 2019; 19: 834–837.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Quantitative evaluation of age‐related changes to pelvic floor muscles in magnetic resonance images from 369 patients

Komemushi

Morimoto³

et al. 2019

Geriatrics Gerontology Int

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“…A sample MRI protocol used for evaluation of inflammatory or neoplastic conditions of the anal canal at our institution is provided in Table . The detailed protocol for MR defecography is available in reference .…”

Section: Technical Considerationsmentioning

confidence: 99%

“…Functional anorectal pain can be caused by levator ani syndrome, unspecified anorectal pain, and proctalgia fugax . Functional defecation disorders include pelvic floor dyssynergia, also known as anismus or spastic pelvic floor syndrome . In pelvic floor dyssynergia, the failure of relaxation or paradoxical contraction of the puborectalis muscle during defecation results in symptoms of constipation, prolonged and incomplete defecation, and delay between opening of the anal canal and initiation of defecation .…”

Section: Pathologic Conditions Of the Anal Canalmentioning

confidence: 99%

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MRI anatomy and pathology of the anal canal

Erlichman

Kanmaniraja

Kobi

et al. 2019

Magnetic Resonance Imaging

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The normal function of the anal sphincter complex is crucial for quality of life, as it is the mechanism by which fecal continence is maintained. Additionally, the anal sphincter complex is an integral part of the coordinated effort of defecation. As imaging plays an important role in assessment of pathologic conditions involving the anal region, understanding the normal anatomy of the anal sphincter complex is important for correct image interpretation and accurate diagnosis. This review discusses the anatomy and function of the anal sphincter complex, important technical considerations for MRI, and various inflammatory, infectious, and neoplastic processes, as well as pathologic structural conditions that affect the anal region. Level of Evidence: 5 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2019;50:1018–1032.

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Longitudinal changes in pelvic organ support among primiparas with postpartum pelvic organ prolapse: A follow‐up magnetic resonance imaging study

Zhao

Zhang

Cui

et al. 2023

Intl J Gynecology & Obste

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Objective To quantify morphological changes of pelvic floor in primiparas with postpartum pelvic organ prolapse (POP) during the early postpartum period. Methods A total of 309 primiparas underwent pelvic floor magnetic resonance imaging (MRI) at 6 weeks postpartum. Those primiparas diagnosed with postpartum POP by MRI criterion were followed up at 3 and 6 months postpartum. Normal primiparas were enrolled in the control group. The puborectal hiatus line, muscular pelvic floor relaxation line, levator hiatus area, iliococcygeus angle, levator plate angle, uterus‐pubococcygeal line, and bladder‐pubococcygeal line were assessed on MRI. Longitudinal changes in pelvic floor measurements between the two groups were compared by repeated‐measures analysis of variance. Results Compared with the control group, enlarged puborectal hiatus line, levator hiatus area, and RICA and decreased uterus‐pubococcygeal line were observed at rest in the POP group (all P < 0.05). All of the pelvic floor measurements were significantly different in the POP group compared with the control group at the maximum Valsalva maneuver (all P < 0.05). All of the pelvic floor measurements showed no significant change over time in both the POP and control groups (all P > 0.05). Conclusions Postpartum POP accompanied by poor pelvic floor support will persist in the early postpartum period.

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Practical guide to dynamic pelvic floor MRI

Abstract: 5 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1155-1170.

Cited by 35 publications

References 82 publications

Quantitative evaluation of age‐related changes to pelvic floor muscles in magnetic resonance images from 369 patients

Quantitative evaluation of age‐related changes to pelvic floor muscles in magnetic resonance images from 369 patients

MRI anatomy and pathology of the anal canal

Longitudinal changes in pelvic organ support among primiparas with postpartum pelvic organ prolapse: A follow‐up magnetic resonance imaging study

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