The role of dynamic magnetic resonance imaging in the diagnosis of pelvic organ prolapse
Dynamic magnetic resonance imaging (dMRI) of the pelvic floor is a valuable tool for diagnosing pelvic organ prolapse. It provides a comprehensive assessment of all anatomical and functional characteristics of the pelvic walls and pelvic organs. Despite the advantages of dMRI, there remains much debate regarding its diagnostic accuracy and correlation with clinical findings. This review presents an analysis of the literature on the capabilities and limitations of dMRI in the diagnosis of pelvic organ prolapse. The etiology, pathogenesis, clinical presentation, and diagnosis of this pathology were reviewed. Dynamic pelvic floor MRI provides a comprehensive assessment of the anatomical and functional characteristics of the pelvis, while being free of ionizing radiation. This method makes it possible to assess the evacuatory function of the visualized structures in dynamics. Simultaneous visualization of all three parts of the pelvic floor using dMRI enables the assessment of multicompartmental disorders, allowing surgical correction in approximately 67% of the cases. Image interpretation is discussed, beginning with viewing three orthogonal T2-weighted sequences acquired at rest to assess baseline anatomy and pelvic organ positioning. Dynamic images were then studied to assess the position of the pelvic organs in relation to the pelvic bones during different phases of straining and gel evacuation from the intestine and vagina.Gilyadova A.V., Ishchenko A.A., Reshetov I.V., Ishchenko A.I., Apolikhina I.A., Saidova A.S., Puchkova E.N., Petrovichev V.S., Mershina E.A., Novruzalieva M.F.
Conclusion: dMRI is characterized by a high resolution and reproducibility. It allows the identification of the pathology of organs and supporting structures of all pelvic areas. dMRI is characterized by a high correlation between acquired findings and clinical data, which is important for patients with a complicated medical history or ambiguous clinical findings, as well as for multicompartment disorders.
Authors' contributions: Gilyadova A.V., Puchkova E.N., Petrovichev V.S., Mershina E.A., Novruzalieva M.F. – data collection and analysis; Gilyadova A.V., Saidova A.S. – manuscript drafting; Ishchenko A.A., Reshetov I.V., Apollikhina I.A., Ishchenko A.I. – manuscript editing.
Conflicts of interest: The authors have no conflicts of interest to declare.
Funding: There was no funding for this study.
For citation: Gilyadova A.V., Ishchenko A.A., Reshetov I.V., Ishchenko A.I., Apolikhina I.A., Saidova A.S., Puchkova E.N., Petrovichev V.S., Mershina E.A., Novruzalieva M.F.
The role of dynamic magnetic resonance imaging in the diagnosis of pelvic organ prolapse. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (4): 28-39 (in Russian)
https://dx.doi.org/10.18565/aig.2023.1
Keywords
pelvic organ prolapse
dynamic magnetic resonance imaging
diagnostic characteristics
T2-weighted sequences
multicompartmental disorders
genital prolapse
pelvic floor dysfunction
vaginal wall prolapse
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Received 09.01.2023
Accepted 28.03.2023
About the Authors
Aida V. Gilyadova, Assistant at the Department of Oncology, Radiotherapy and Plastic Surgery, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University); obstetrician-gynecologist, NMRC “Treatment and Rehabilitation”, Ministry of Health of Russia, aida-benyagueva@mail.ru, https://orcid.org/0000-0003-4343-4813,119991, Russia, Moscow, Trubetskaya str., 8-2.
Anton A. Ishchenko, PhD, Head of the Clinic of Gynecology, Reproductive and Aesthetic Medicine, NMRC “Treatment and Rehabilitation”, Ministry of Health of Russia, ra2001_2001@mail.ru, https://orcid.org/0000-0001-6673-3934, 125367, Russia, Moscow, Ivankovskoe highway, 3.
Igor V. Reshetov, Academician of the RAS, Dr. Med. Sci., Professor, Head of the Department of Oncology, Radiotherapy and Plastic Surgery, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University); Director of the Institute of Cluster Oncology
named after Prof. L.L. Levshin, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University), reshetoviv@mail.ru, https://orcid.org/0000-0002-0909-6278, 119991, Russia, Moscow, Trubetskaya str., 8-2.
Anatoly I. Ishchenko, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology No.1, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University); Director of the V.F. Snegirev Obstetrics and Gynecology Clinic, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University), 7205502@mail.ru, https://orcid.org/0000-0003-3338-1113, 119991, Russia, Moscow, Trubetskaya str., 8-2.
Inna A. Apolikhina, Dr. Med. Sci., Professor, Head of the Department of Aesthetic Gynecology and Development, V.I. Kulakov NMRC for AG&P, Ministry of Health of Russia; Professor of the Department of Obstetrics, Gynecology, Perinatology and Reproductology, Institute of Vocational Education, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University), i_apolikhina@oparina4.ru, https://orcid.org/0000-0002-4581-6295, 117997, Russia, Moscow, Academician Oparin str., 4.
Aina S. Saidova, PhD, obstetrician-gynecologist of the Department of Aesthetic Gynecology and Fetus, V.I. Kulakov NMRC for AG&P, Ministry of Health of Russia, a_saidova@oparina4.ru; https://orcid.org/0000-0003-3473-3109, 117997, Russia, Moscow, Academician Oparin str., 4.
Elena N. Puchkova, PhD, radiologist of the highest category, Clinical Hospital "Lapino" GC "Mother and Child", milleyk@mail.ru, https://orcid.org/0000-0002-7743-0549, 143081, Russia, Moscow region, Odintsovsky urban district, Lapino, 1st Uspenskoe highway, 111.
Viktor S. Petrovichev, PhD, Head of the Imaging Department, Center for Radiation Diagnostics, NMRC “Treatment and Rehabilitation”, Ministry of Health of Russia, petrovi4ev@gmail.com, https://orcid.org/0000-0002-8391-2771, 125367, Russia, Moscow, Ivankovskoe highway, 3.
Elena A. Mershina, PhD, Associate Professor, Department of Radiation Diagnostics and Radiation Therapy, Lomonosov Moscow State University; Head of the Department of X-ray Diagnostics with MRI and CT Departments, Lomonosov Moscow State University MNOC, elena_mershina@mail.ru, https://orcid.org/0000-0002-1266-4926, 119192, Russia, Moscow, Lomonosovsky Ave., 27-10.
Muminat F. Novruzalieva, student, Faculty of Medical Medicine, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University), ms.muminat@bk.ru, https://orcid.org/0000-0003-4654-9405, 117997, Russia, Moscow, Academician Oparin str., 4.
Corresponding author: Aida V. Gilyadova, aida-benyagueva@mail.ru
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