Female pelvic organ prolapse: A comparison of triphasic dynamic MR imagingand triphasic fluoroscopic cystocolpoproctography

OBJECTIVE. This study compared dynamic MR imaging with fluoroscopic cystoco lpoproctography for the detection and measurement of prolapse of pelvic org ans. SUBJECTS AND METHODS. Ten patients underwent triphasic dynamic MR imaging a nd triphasic fluoroscopic cystocolpoproctography with identical amounts of contrast material to opacify the bladder, vagina, and rectum. The dynamic M R imaging procedure included cine-loop presentation. Each examination was a nalyzed to determine the presence and extent of prolapse of pelvic organs b ased on specific measurements. RESULTS. Both dynamic MR imaging and fluoroscopic cystocolpoproctography re vealed 10 rectoceles (mean extents, 2.85 and 2.45 cm, respectively). Nine c ystoceles were revealed by both dynamic MR imaging (mean extent, 4.05 cm) a nd fluoroscopy (mean extent, 4.55 cm). Seven enteroceles were revealed, one of which was initially not seen on dynamic MR imaging. Two sigmoidoceles w ere revealed, one of which was not seen on fluoroscopy. The mean extent of the enteroceles and sigmoidoceles on dynamic MR imaging was 3.50 cm, and th e mean extent on fluoroscopy was 4.25 cm. Nine of the 10 patients were able to defecate in the supine position on the MR imaging table. Patients were divided equally in their preference for dynamic MR imaging or fluoroscopic cystocolpoproctography. CONCLUSION. Triphasic dynamic MR imaging and triphasic fluoroscopic cystoco lpoprocrograpy show similar detection rates for prolapse of pelvic organs. Although dynamic MR imaging underestimates the extent of cystoceles and ent eroceles, it has the advantage of revealing all pelvic organs and the pelvi c floor musculature in a multiplanar cine-loop presentation.