Skip to main content
Erschienen in: International Urogynecology Journal 9/2013

01.09.2013 | Editors' Choice: Clinical Opinion

On pelvic reference lines and the MR evaluation of genital prolapse: a proposal for standardization using the Pelvic Inclination Correction System

verfasst von: C. Betschart, L. Chen, J. A. Ashton-Miller, J. O. L. DeLancey

Erschienen in: International Urogynecology Journal | Ausgabe 9/2013

Einloggen, um Zugang zu erhalten

Abstract

Five midsagittal pelvic reference lines have been employed to quantify prolapse using MRI. However, the lack of standardization makes study results difficult to compare. Using MRI scans from 149 women, we demonstrate how use of existing reference lines can systematically affect measurements in three distinct ways: in oblique line systems, distances measured to the reference line vary with antero-posterior location; soft issue-based reference lines can underestimate organ movement relative to the pelvic bones; and systems defined relative to the MR scanner are affected by intra- and interindividual differences in the pelvic inclination angle at rest and strain. Thus, we propose a standardized approach called the Pelvic Inclination Correction System (PICS). Based on bony structures and the body axis, the PICS system corrects for variation in pelvic inclination, at rest of straining, and allows for the standardized measurement of organ displacement in the direction of prolapse.
Anhänge
Nur mit Berechtigung zugänglich
Fußnoten
1
By international convention, images made in the sagittal plane are displayed as if an individual were in the upright position, even though the images are made with an individual in the supine position. In this commentary we will continue the established practice of referring to directions in the image, recognizing that they are perpendicular to the way in which the scan is made.
 
Literatur
1.
Zurück zum Zitat Yang A, Mostwin JL, Rosenshein NB, Zerhouni EA (1991) Pelvic floor descent in women: dynamic evaluation with fastMR 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 fastMR imaging and cinematic display. Radiology 179:25–33PubMed
2.
Zurück zum Zitat Singh K, Reid WM, 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 WM, Berger LA (2001) Assessment and grading of pelvic organ prolapse by use of dynamic magnetic resonance imaging. Am J Obstet Gynecol 185:71–77PubMedCrossRef
3.
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
4.
Zurück zum Zitat Fauconnier A, Zaeski E, Abichedid J, Bader G, Falissard B, Fritel X (2007) Dynamic magnetic resonance imaging for grading pelvic organ prolapse according to the International Continence Society Classification: which line should be used? Neurourol Urodyn 27:191–197CrossRef Fauconnier A, Zaeski E, Abichedid J, Bader G, Falissard B, Fritel X (2007) Dynamic magnetic resonance imaging for grading pelvic organ prolapse according to the International Continence Society Classification: which line should be used? Neurourol Urodyn 27:191–197CrossRef
5.
Zurück zum Zitat Broekhuis SR, Fütterer JJ, Barentsz JO, Vierhout ME, Kluivers KB (2009) A systematic review of clinical studies on dynamic magnetic resonance imaging of pelvic organ prolapse: the use of reference lines and anatomical landmarks. Int Urogynecol J 20(6):721–729CrossRef Broekhuis SR, Fütterer JJ, Barentsz JO, Vierhout ME, Kluivers KB (2009) A systematic review of clinical studies on dynamic magnetic resonance imaging of pelvic organ prolapse: the use of reference lines and anatomical landmarks. Int Urogynecol J 20(6):721–729CrossRef
6.
Zurück zum Zitat Kall BA, Kelly PJ, Goerss S, Frieder G (1985) Methodology and clinical experience with computed tomography and a computer-resident stereotactic atlas. Neurosurgery 17(3):400–407PubMedCrossRef Kall BA, Kelly PJ, Goerss S, Frieder G (1985) Methodology and clinical experience with computed tomography and a computer-resident stereotactic atlas. Neurosurgery 17(3):400–407PubMedCrossRef
7.
Zurück zum Zitat Unterweger M, Marincek B, Gottstein-Aalame N, Debatin JF, Seifert B, Ochsenbein-Imhof N, Perucchini D, Kubic-Huch RA (2001) Ultrafast MR Imaging of the pelvic floor. AJR Am J Roentgenol 176:959–963PubMedCrossRef Unterweger M, Marincek B, Gottstein-Aalame N, Debatin JF, Seifert B, Ochsenbein-Imhof N, Perucchini D, Kubic-Huch RA (2001) Ultrafast MR Imaging of the pelvic floor. AJR Am J Roentgenol 176:959–963PubMedCrossRef
8.
Zurück zum Zitat Goodrich MA, Webb MJ, King BF, Bampton AE, Cameau NG, Riederer SJ (1993) Magnetic resonance imaging of pelvic floor relaxation: dynamic analysis and evaluation of patients before and after surgical repair. Obstet Gynecol 82:883–891PubMed Goodrich MA, Webb MJ, King BF, Bampton AE, Cameau NG, Riederer SJ (1993) Magnetic resonance imaging of pelvic floor relaxation: dynamic analysis and evaluation of patients before and after surgical repair. Obstet Gynecol 82:883–891PubMed
9.
Zurück zum Zitat Lienemann A, Anthuber C, Baron A, Kohz P, Reiser M (1997) Dynamic MR colpocystorectography assessing pelvic-floor descent. Eur Radiol 7:1309–1317PubMedCrossRef Lienemann A, Anthuber C, Baron A, Kohz P, Reiser M (1997) Dynamic MR colpocystorectography assessing pelvic-floor descent. Eur Radiol 7:1309–1317PubMedCrossRef
10.
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
11.
Zurück zum Zitat Noll LE, Hutch JA (1969) The SCIPP line—an aid in interpreting the voiding lateral cystourethrogram. Obstet Gynecol 33:680–689PubMed Noll LE, Hutch JA (1969) The SCIPP line—an aid in interpreting the voiding lateral cystourethrogram. Obstet Gynecol 33:680–689PubMed
12.
Zurück zum Zitat Agildere AM, Tarhan NC, Ergeneli MH, Yologlu Z, Kurt A, Akgun S, Kazahan EM (2003) MR rectography evaluation of rectoceles with oral gadopentetate dimeglumine and polyethylene glycol solution. Abdom Imaging 28:28–35PubMedCrossRef Agildere AM, Tarhan NC, Ergeneli MH, Yologlu Z, Kurt A, Akgun S, Kazahan EM (2003) MR rectography evaluation of rectoceles with oral gadopentetate dimeglumine and polyethylene glycol solution. Abdom Imaging 28:28–35PubMedCrossRef
13.
Zurück zum Zitat Bump RC, Mattiasson A, Bø K, Brubaker LP, DeLancey JO, Klarskov P, Shull BL, Smith AR (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Obstet Gynecol 175(1):10–17CrossRef Bump RC, Mattiasson A, Bø K, Brubaker LP, DeLancey JO, Klarskov P, Shull BL, Smith AR (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Obstet Gynecol 175(1):10–17CrossRef
14.
Zurück zum Zitat Summers A, Winkel LA, Hussain HK, DeLancey JO (2006) The relationship between anterior and apical compartment support. Am J Obstet Gynecol 194(5):1438–1443PubMedCrossRef Summers A, Winkel LA, Hussain HK, DeLancey JO (2006) The relationship between anterior and apical compartment support. Am J Obstet Gynecol 194(5):1438–1443PubMedCrossRef
15.
Zurück zum Zitat Wu G, Cavanagh PR (1995) ISB recommendations for standardization in the reporting of kinematic data. J Biomech 28:1257–1261PubMedCrossRef Wu G, Cavanagh PR (1995) ISB recommendations for standardization in the reporting of kinematic data. J Biomech 28:1257–1261PubMedCrossRef
16.
Zurück zum Zitat Roussouly P, Gollogly S, Berthonnaud E, Dimnet J (2005) Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine 30:346–353PubMedCrossRef Roussouly P, Gollogly S, Berthonnaud E, Dimnet J (2005) Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine 30:346–353PubMedCrossRef
17.
Zurück zum Zitat Broekhuis SR, Kluivers KB, Hendriks JC, Vierhout ME, Barentsz JO, Fütterer JJ (2009) Dynamic magnetic resonance imaging: reliability of anatomical landmarks and reference lines used to assess pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 20:141–148PubMedCrossRef Broekhuis SR, Kluivers KB, Hendriks JC, Vierhout ME, Barentsz JO, Fütterer JJ (2009) Dynamic magnetic resonance imaging: reliability of anatomical landmarks and reference lines used to assess pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 20:141–148PubMedCrossRef
Metadaten
Titel
On pelvic reference lines and the MR evaluation of genital prolapse: a proposal for standardization using the Pelvic Inclination Correction System
verfasst von
C. Betschart
L. Chen
J. A. Ashton-Miller
J. O. L. DeLancey
Publikationsdatum
01.09.2013
Verlag
Springer London
Erschienen in
International Urogynecology Journal / Ausgabe 9/2013
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-013-2100-4

Weitere Artikel der Ausgabe 9/2013

International Urogynecology Journal 9/2013 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.