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Erschienen in: International Urogynecology Journal 6/2009

01.06.2009 | Original Article

Magnetic resonance imaging of pelvic organ prolapse: comparing pubococcygeal and midpubic lines with clinical staging

verfasst von: Courtney A. Woodfield, Brittany Star Hampton, Vivian Sung, Jeffrey M. Brody

Erschienen in: International Urogynecology Journal | Ausgabe 6/2009

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Abstract

Introduction and hypothesis

The aim of the study was to determine which magnetic resonance imaging (MRI) reference line for staging pelvic organ prolapse, the pubococcygeal line (PCL) vs. the midpubic line (MPL), has the highest agreement with clinical staging.

Methods

A retrospective study of women with pelvic floor complaints who underwent dynamic pelvic MRI from January 2004 to April 2007 was conducted. Two radiologists staged descent on MRI for each pelvic compartment (anterior, apical, posterior) by consensus, using PCL and MPL reference lines. Agreement between MRI and clinical staging was estimated using weighted kappas.

Results

Twenty women were included. Agreement between clinical and PCL staging was fair in the anterior (κ = 0.29) and poor in the apical (κ = 0.03) and posterior (κ = 0.08) compartments. Agreement between clinical and MPL staging was fair in the anterior (κ = 0.37), apical (κ = 0.31), and posterior (κ = 0.25) compartments.

Conclusions

The MPL has higher agreement with clinical staging than the PCL. However, neither reference line has good agreement with clinical staging.
Literatur
1.
Zurück zum Zitat Hetzer FH, Andreisek G, Tsagari C, Sahrbacher U, Weishaupt D (2006) MR defecography in patients with fecal incontinence: imaging findings and their effect on surgical management. Radiology 240:449–457PubMedCrossRef Hetzer FH, Andreisek G, Tsagari C, Sahrbacher U, Weishaupt D (2006) MR defecography in patients with fecal incontinence: imaging findings and their effect on surgical management. Radiology 240:449–457PubMedCrossRef
2.
Zurück zum Zitat Kelvin FM, Hale DS, Maglinte DD, Patten BJ, Benson JT (1999) Female pelvic organ prolapse: diagnostic contribution of dynamic cystoproctography and comparison with physical examination. AJR 173:31–37PubMed Kelvin FM, Hale DS, Maglinte DD, Patten BJ, Benson JT (1999) Female pelvic organ prolapse: diagnostic contribution of dynamic cystoproctography and comparison with physical examination. AJR 173:31–37PubMed
3.
Zurück zum Zitat Etlik Ö, Arslan H, Odabaşi O, Odabaşi H, Harman M, Celebi H, Sakarya ME (2005) The role of the MR-fluoroscopy in the diagnosis and staging of the pelvic organ prolapse. Eur J Radiol 53:136–141PubMedCrossRef Etlik Ö, Arslan H, Odabaşi O, Odabaşi H, Harman M, Celebi H, Sakarya ME (2005) The role of the MR-fluoroscopy in the diagnosis and staging of the pelvic organ prolapse. Eur J Radiol 53:136–141PubMedCrossRef
4.
Zurück zum Zitat Kelvin FM, Maglinte DDT, Hale DS, Benson JT (2000) Female pelvic organ prolapse: a comparison of triphasic dynamic MR imaging and triphasic fluoroscopic cystocolpoproctography. AJR 174:81–88PubMed Kelvin FM, Maglinte DDT, Hale DS, Benson JT (2000) Female pelvic organ prolapse: a comparison of triphasic dynamic MR imaging and triphasic fluoroscopic cystocolpoproctography. AJR 174:81–88PubMed
5.
Zurück zum Zitat Cortes E, Reid WMN, Singh K, Berger L (2004) Clinical examination and dynamic magnetic resonance imaging in vaginal vault prolapse. Obstet Gynecol 103:41–46PubMed Cortes E, Reid WMN, Singh K, Berger L (2004) Clinical examination and dynamic magnetic resonance imaging in vaginal vault prolapse. Obstet Gynecol 103:41–46PubMed
6.
Zurück zum Zitat Kaufman HS, Buller JL, Thompson JR, Pannu HK, DeMeester SL, Genadry RR et al (2001) Dynamic pelvic magnetic resonance imaging and cystocolpoproctography alter surgical management of pelvic floor disorders. Dis Colon Rectum 44:1575–1583PubMedCrossRef Kaufman HS, Buller JL, Thompson JR, Pannu HK, DeMeester SL, Genadry RR et al (2001) Dynamic pelvic magnetic resonance imaging and cystocolpoproctography alter surgical management of pelvic floor disorders. Dis Colon Rectum 44:1575–1583PubMedCrossRef
7.
Zurück zum Zitat Lienemann A, Sprenger D, Janßen U, Grosch E, Pellengahr C, Anthuber C (2004) Assessment of pelvic organ descent by use of functional cine-MRI: which reference line should be used? Neurourol Urodyn 23:33–37PubMedCrossRef Lienemann A, Sprenger D, Janßen U, Grosch E, Pellengahr C, Anthuber C (2004) Assessment of pelvic organ descent by use of functional cine-MRI: which reference line should be used? Neurourol Urodyn 23:33–37PubMedCrossRef
8.
Zurück zum Zitat Gufler H, Laubenberger J, DeGregorio G, Dohnicht S, Langer M (1999) Pelvic floor descent: MR imaging using a half-Fourier RARE sequence. J Magn Reson Imaging 9:378–383PubMedCrossRef Gufler H, Laubenberger J, DeGregorio G, Dohnicht S, Langer M (1999) Pelvic floor descent: MR imaging using a half-Fourier RARE sequence. J Magn Reson Imaging 9:378–383PubMedCrossRef
9.
Zurück zum Zitat Comiter CV, Vasavada SP, Barbaric ZL, Gousse AE, Raz S (1999) Grading pelvic prolapse and pelvic floor relaxation using dynamic magnetic resonance imaging. Urology 54:454–457PubMedCrossRef Comiter CV, Vasavada SP, Barbaric ZL, Gousse AE, Raz S (1999) Grading pelvic prolapse and pelvic floor relaxation using dynamic magnetic resonance imaging. Urology 54:454–457PubMedCrossRef
10.
Zurück zum Zitat Yang A, Mostwin JL, Rosenshein NB, Zerhouni EA (1991) Pelvic floor descent in women: dynamic evaluation with fast MR imaging and cinematic display. Radiology 179:25–33PubMed Yang A, Mostwin JL, Rosenshein NB, Zerhouni EA (1991) Pelvic floor descent in women: dynamic evaluation with fast MR imaging and cinematic display. Radiology 179:25–33PubMed
11.
Zurück zum Zitat Singh K, Reid WMN, Berger LA (2001) Assessment and grading of pelvic organ prolapse by use of dynamic magnetic resonance imaging. Am J Obstet Gynecol 185:71–77PubMedCrossRef Singh K, Reid WMN, Berger LA (2001) Assessment and grading of pelvic organ prolapse by use of dynamic magnetic resonance imaging. Am J Obstet Gynecol 185:71–77PubMedCrossRef
12.
Zurück zum Zitat Bump RC, Mattiasson A, Bø K, Brubaker LP, DeLancey JOL, Klarskov P, Shull BL, Smith ARB (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17PubMedCrossRef Bump RC, Mattiasson A, Bø K, Brubaker LP, DeLancey JOL, Klarskov P, Shull BL, Smith ARB (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17PubMedCrossRef
13.
Zurück zum Zitat Hodroff MA, Stolpen AH, Denson MA, Bolinger L, Kreder KJ (2002) Dynamic magnetic resonance imaging of the female pelvis: the relationship with the pelvic organ prolapse quantification staging system. J Urol 167:1353–1355PubMedCrossRef Hodroff MA, Stolpen AH, Denson MA, Bolinger L, Kreder KJ (2002) Dynamic magnetic resonance imaging of the female pelvis: the relationship with the pelvic organ prolapse quantification staging system. J Urol 167:1353–1355PubMedCrossRef
14.
Zurück zum Zitat Bertschinger KM, Hetzer FH, Roos JE, Treiber K, Marincek B, Kilfiker PR (2002) Dynamic MR imaging of the pelvic floor performed with patient sitting in an open-magnet unit versus patient supine in a closed-magnet unit. Radiology 223:501–508PubMedCrossRef Bertschinger KM, Hetzer FH, Roos JE, Treiber K, Marincek B, Kilfiker PR (2002) Dynamic MR imaging of the pelvic floor performed with patient sitting in an open-magnet unit versus patient supine in a closed-magnet unit. Radiology 223:501–508PubMedCrossRef
15.
Zurück zum Zitat Altman DG (1991) Practical statistics for medical research. Chapman and Hall, London Altman DG (1991) Practical statistics for medical research. Chapman and Hall, London
Metadaten
Titel
Magnetic resonance imaging of pelvic organ prolapse: comparing pubococcygeal and midpubic lines with clinical staging
verfasst von
Courtney A. Woodfield
Brittany Star Hampton
Vivian Sung
Jeffrey M. Brody
Publikationsdatum
01.06.2009
Verlag
Springer-Verlag
Erschienen in
International Urogynecology Journal / Ausgabe 6/2009
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-009-0865-2

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