A protocol for dynamic magnetic resonance imaging of the pelvic floor

Area of Science:

• Medical Imaging
• Pelvic Floor Disorders
• Gastroenterology

Background:

• Current dynamic MRI protocols for pelvic floor dysfunction lack standardization, hindering result interpretation and comparison.
• Investigator-dependent methods lead to variability in diagnostic accuracy.

Purpose of the Study:

• To describe a standardized, practical, and cost-effective dynamic MRI protocol for evaluating pelvic floor dysfunction.
• To assess the utility of T2-weighted dynamic MRI with rectal contrast for identifying and quantifying pelvic compartment dynamics.

Main Methods:

• A T2-weighted dynamic MRI protocol was developed using standard equipment and rectal hydro-gel contrast.
• Fifteen patients with evacuation difficulties underwent imaging in rest, strain, and evacuation phases.
• Extensive patient training and optimized imaging parameters ensured high image quality and efficiency.

Main Results:

• The protocol achieved high image quality with a 14-second acquisition time per phase.
• The evacuation phase was crucial for identifying compartment dysfunction and prolapse.
• Management plans were altered in 67% of patients based on the dynamic MRI findings.

Conclusions:

• A standardized T2-weighted dynamic MRI protocol with rectal contrast is effective for evaluating pelvic floor dysfunction.
• This practical and cost-effective method improves diagnostic accuracy and influences clinical decision-making.
• The evacuation phase provides critical insights into functional abnormalities.