Pelvic floor imaging in asymptomatic subjects.

Area of Science:

• Pelvic floor imaging
• Functional imaging
• Diagnostic imaging

Background:

• Establishing normal imaging parameters for the pelvic floor is crucial for accurate diagnosis.
• Total pelvic floor ultrasound (TPFUS) and defaecation MRI (dMRI) are advanced imaging modalities.
• Understanding variations in asymptomatic individuals is key to interpreting findings in symptomatic patients.

Purpose of the Study:

• To determine the range of normal imaging features observed during total pelvic floor ultrasound (TPFUS) and defaecation MRI (dMRI).
• To assess the prevalence of specific pelvic floor abnormalities in asymptomatic female volunteers.

Main Methods:

• Prospective investigation of 20 asymptomatic female volunteers (mean age 36.5 years).
• Utilized both defaecation MRI (dMRI) and total pelvic floor ultrasound (TPFUS) including transperineal, transvaginal, endovaginal, and endoanal approaches.
• Subjects completed validated symptom questionnaires; imaging was interpreted by blinded clinicians.

Main Results:

• Abnormal findings were detected on both dMRI and TPFUS in asymptomatic subjects.
• A high rate of functional features was observed on dMRI (12/20), with some also seen on TPFUS (4/20).
• Specific findings included rectocoele, intussusception, enterocoele, and cystocoele in a subset of volunteers.

Conclusions:

• The study demonstrates that abnormal imaging findings can be present in asymptomatic individuals using dMRI and TPFUS.
• There is a wide spectrum of imaging findings in healthy subjects, emphasizing the need for careful interpretation.
• While not large enough to redefine normal parameters, the findings are valuable for understanding variations in health.