A Protocol for dynamic magnetic resonance imaging of the pelvic floor

Abstract

Methods of dynamic magnetic resonance imaging (dMRI) of the pelvic floor vary among centers making interpretation investigator-dependent and comparison of results difficult. We describe a protocol utilizing standard MRI equipment, which achieves high image quality while remaining practical and cost-effective. Fifteen patients, with difficulty in evacuation of stool, underwent dMRI. Each patient was trained prior to the procedure. The pelvis was mapped in the sagittal plane using T2-weighted dMRI in rest, strain and evacuation phases with rectal hydro-gel as contrast. Images obtained were used to identify and quantify the dynamics of each pelvic compartment. Acquisition time for each phase was 14 seconds. Extensive patient instruction and T2-weighted dMRI with rectal contrast optimized image quality and efficiency. The evacuation phase yielded data on the extent of dysfunction and compartment prolapse, not seen in the other phases. These findings led to change in management in 67 % (n=10) of patients.