Dynamic magnetic resonance imaging advised to detect pelvic organ prolapse

Dynamic magnetic resonance imaging (MRI) of the urethra, along with static MRI, may benefit women who are experiencing lower urinary tract symptoms by helping to detect pelvic organ prolapse, according to researchers at New York University Medical Center's Department of Radiology.

The study of 84 women, aged 18 to 81 years, with lower urinary tract symptoms used dynamic and static MRI of the urethra using multiplanar T2-weighted turbo spin-echo and unenhanced and contrast-enhanced gradient-echo sequences.

Fisher's exact and Mann-Whitney tests were used to correlate MRI results with clinical symptoms. For the dynamic sequence, women switched between rest and maximal strain during the testing process.

Dynamic MRI alone detected 87.9% of the 33 women with pelvic organ prolapse. These women were diagnosed as having a structurally normal urethra. Further, MRI identified 13 cystoceles and 17 cases of urethral hypermobility not identified in the physical examination.

Anterior compartment prolapse was more common in women with stress urinary incontinence, more vaginal deliveries, increased voiding frequency, and challenges in voiding (P<.05).

Bennett GL, Hecht EM, Tanpitukpongse TP, et al. MRI of the urethra in women with lower urinary tract symptoms: spectrum of findings at static and dynamic imaging. AJR Am J Roentgenol. 2009;193(6):1708-1715.