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MRI for pelvic floor dysfunction: can the strain phase be eliminated?

Sasha N Bhan1, Gevork N Mnatzakanian1, Rosane Nisenbaum2

  • 1Department of Medical Imaging, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.

Abdominal Radiology (New York)
|February 13, 2016
PubMed
Summary

The strain phase of MR defecography (MRD) is redundant. Eliminating this phase streamlines the examination without losing diagnostic information, simplifying patient instructions and reducing reporting time.

Keywords:
DefecographyEvacuation phaseMagnetic resonance imagingPelvic floor dysfunctionStrain phase

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Area of Science:

  • Radiology
  • Pelvic Floor Imaging

Background:

  • MR defecography (MRD) is a key imaging modality for evaluating pelvic floor dysfunction.
  • The standard MRD protocol includes both strain and evacuation phases.

Purpose of the Study:

  • To determine if the strain phase of MRD is redundant.
  • To assess if the strain phase can be eliminated without compromising diagnostic yield.

Main Methods:

  • Retrospective review of 80 MRD examinations.
  • Two blinded radiologists evaluated strain and evacuation phases for pelvic floor abnormalities.
  • Statistical analysis using paired t test and McNemar's test.

Main Results:

  • The evacuation phase identified all abnormalities seen in the strain phase.
  • The evacuation phase revealed significantly more and pronounced abnormalities (e.g., cystocele, rectocele, enterocele).
  • Mean posterior compartment descent was significantly greater during the evacuation phase (p < 0.0001).

Conclusions:

  • The strain phase of MRD is diagnostically redundant.
  • Eliminating the strain phase can streamline MRD protocols.
  • This optimization reduces imaging and reporting time while simplifying patient instructions.