Functional MRI of the pelvic floor. Method and references values

Purpose. Functional cine MRI of the pelvic floor is a yet another modality in addition to various radiological fluoroscopic techniques. This article d escribes our own method in view of the recent literatur and provides morpho metric reference values. Material and method. We examined 20 nulliparous women (range of age: 25-51 years) with normal findings in the gynecological and urodynamic examination . Functional cine MRI was performed on a 1.5 Tesla equipment after opacific ation of the vagina and rectum. We used a T2-weighted gradient- echo sequen ce (Ture-FISP) to determine the position of the reference organs at rest an d du ring straining/defecation. Two different reference lines were used. In addition 29 morphometric and functional parameters were measured, all of t hem being observer independant. Results. Functional cine MRI was able to show the extent and interaction of the pelvic floor organs in all cases with the reference organs always rema ining above the pubococcygeal reference line. The depht of the rectocele wa s 2 cm. With the exception of the diameter of urogenital hiatus the differe nt parts of the levator ani muscle could not be determined. Discussion. Functional cine MRI using an appropiate organ opacification and slice positioning is an objective, unifying diagnostic approach of the pel vic floor. The reference data given can be of help to distinguish normal fr om abnormal findings.