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European Radiology
Published in: European Radiology 5/2017

Open Access 01-05-2017 | Magnetic Resonance

Magnetic resonance imaging of pelvic floor dysfunction - joint recommendations of the ESUR and ESGAR Pelvic Floor Working Group

Authors: Rania Farouk El Sayed, Celine D. Alt, Francesca Maccioni, Matthias Meissnitzer, Gabriele Masselli, Lucia Manganaro, Valeria Vinci, Dominik Weishaupt, On behalf of the ESUR and ESGAR Pelvic Floor Working Group

Published in: European Radiology | Issue 5/2017

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Abstract

Objective

To develop recommendations that can be used as guidance for standardized approach regarding indications, patient preparation, sequences acquisition, interpretation and reporting of magnetic resonance imaging (MRI) for diagnosis and grading of pelvic floor dysfunction (PFD).

Methods

The technique included critical literature between 1993 and 2013 and expert consensus about MRI protocols by the pelvic floor-imaging working group of the European Society of Urogenital Radiology (ESUR) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) from one Egyptian and seven European institutions. Data collection and analysis were achieved in 5 consecutive steps. Eighty-two items were scored to be eligible for further analysis and scaling. Agreement of at least 80 % was defined as consensus finding.

Results

Consensus was reached for 88 % of 82 items. Recommended reporting template should include two main sections for measurements and grading. The pubococcygeal line (PCL) is recommended as the reference line to measure pelvic organ prolapse. The recommended grading scheme is the “Rule of three” for Pelvic Organ Prolapse (POP), while a rectocele and ARJ descent each has its specific grading system.

Conclusion

This literature review and expert consensus recommendations can be used as guidance for MR imaging and reporting of PFD.

Key points

• These recommendations highlight the most important prerequisites to obtain a diagnostic PFD-MRI.
• Static, dynamic and evacuation sequences should be generally performed for PFD evaluation.
• The recommendations were constructed through consensus among 13 radiologists from 8 institutions.
Appendix
Available only for authorised users
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Metadata
Title
Magnetic resonance imaging of pelvic floor dysfunction - joint recommendations of the ESUR and ESGAR Pelvic Floor Working Group
Authors
Rania Farouk El Sayed
Celine D. Alt
Francesca Maccioni
Matthias Meissnitzer
Gabriele Masselli
Lucia Manganaro
Valeria Vinci
Dominik Weishaupt
On behalf of the ESUR and ESGAR Pelvic Floor Working Group
Publication date
01-05-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 5/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4471-7

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