Standing open magnetic resonance imaging improves detection and staging of pelvic organ prolapse

Introduction: The role of imaging in pelvic organ prolapse (POP) assessment is unclear. Open magnetic resonance imaging (MRI) systems have a configuration that allows for imaging women with POP in different positions. Herein, we use a 0.5 Tesla open MRI to obtain supine, seated, and standing images. We then compare these images to evaluate the impact of posture on detection and staging of POP. Methods: Women presenting with symptoms of POP at a tertiary care university hospital were asked to participate in this prospective cohort study. Symptom scores, POP-Q staging and three-position MRI imaging of the pelvis data were collected. The pubococcygeal line (PCL) was used to quantify within-patient changes in pelvic organ position as defined by: no displacement, <1 cm inferior to the PCL, mild (1–3 cm), moderate (3.1–6 cm), and severe (>6 cm) in the axial and sagittal T2-weighted images. Statistical analysis was completed (T-test; p<0.05 significant). Results: A total of 42 women, age range 40–78 years, participated. There was a significant difference in the mean values associated with anterior prolapse in the supine (0.7±1.8), seated (2.4±3.4), and upright (4.2±1.6) positions (p=0.015). There was a significant difference in the mean values associated with apical prolapse in the supine (0.5±1.5), seated (1.5±1.4), and upright (2.1±1.5) positions (p=0.036). Conclusions: Our findings suggest that POP is more readily detected and upstaged with standing MRI images as compared to supine and seated positions. The developed two-minute standing MRI protocol may enable clinicians to better assess the extent of POP.

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Relevance of open magnetic resonance imaging position (sitting and standing) to quantify pelvic organ prolapse in women

Canadian Urological Association Journal ◽

10.5489/cuaj.5186 ◽

2018 ◽

Vol 12 (11) ◽

Cited By ~ 2

Author(s):

Marwa Abdulaziz ◽

Alex Kavanagh ◽

Lynn Stothers ◽

Andrew J. Macnab

Keyword(s):

Magnetic Resonance Imaging ◽

Pelvic Organ Prolapse ◽

Magnetic Resonance ◽

Symptom Severity ◽

Standing Position ◽

Pelvic Organ ◽

Upward Movement ◽

Resonance Imaging ◽

Downward Movement ◽

Open Magnetic Resonance Imaging

Introduction: In pelvic organ prolapse (POP), posture and gravity impact organ position and symptom severity. The advanced magnet configuration in open magnetic resonance imaging (MRO) allows patients to be imaged when sitting and standing, as well in a conventional supine position. This study evaluated if sitting and standing MRO images are relevant as a means of improving quantification of POP because they allow differences in organ position not seen on supine imaging to be identified.Methods: Forty women recruited from a university urogynecology clinic had MRO imaging (0.5 T scanner) with axial and sagittal T2-weighted pelvic scans obtained when sitting, standing, and supine. Pelvic reference lines were used to quantify the degree of POP, and the relevance of imaging position on the detection of POP compared.Results: Images from 40 participants were evaluated (20 with POP and 20 asymptomatic controls). Our results indicate that the maximal extent of prolapse is best evaluated in the standing position using H line, M line, mid-pubic line, and perineal line as reference lines to determine POP.Conclusions: MRO imaging of symptomatic patients in a standing position is relevant in the quantification of POP. Compared with supine images, standing imaging identifies that greater levels of downward movement in the anterior and posterior compartments occur, presumably under the influence of posture and gravity. In contrast, no appreciable benefit was afforded by imaging in the sitting position, which precluded use of some reference lines due to upward movement of the anorectal junction.

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PD29-07 POSITIONAL PELVIC ORGAN PROLAPSE (POP) EVALUATION USING OPEN MAGNETIC RESONANCE IMAGING (MRO)

The Journal of Urology ◽

10.1016/j.juro.2014.02.2142 ◽

2014 ◽

Vol 191 (4S) ◽

Author(s):

Boris Friedman ◽

Lynn Stothers ◽

Darren Lazare ◽

Macnab Andrew

Keyword(s):

Magnetic Resonance Imaging ◽

Pelvic Organ Prolapse ◽

Magnetic Resonance ◽

Pelvic Organ ◽

Resonance Imaging ◽

Open Magnetic Resonance Imaging

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Does diffusion-weighted magnetic resonance imaging have a place in the differential diagnosis of brucella sacroiliitis and seronegative spondyloarthropathy?

Acta Radiologica ◽

10.1177/0284185120938370 ◽

2020 ◽

pp. 028418512093837

Author(s):

Sunay Sibel Karayol ◽

Kudret Cem Karayol

Keyword(s):

Magnetic Resonance Imaging ◽

Bone Marrow ◽

Differential Diagnosis ◽

Magnetic Resonance ◽

Control Group ◽

Resonance Imaging ◽

Visual Evaluation ◽

Mean Values ◽

Diffusion Weighted ◽

The Mean

Background The aim of this study is to investigate the role of diffusion-weighted imaging (DWI) in the differential diagnosis of sacroiliitis. Purpose To compare the sacroiliac magnetic resonance imaging (MRI) examinations of patients with suspected active sacroiliitis with patients with acute SpA MR findings and the DWI examinations of patients with acute brucella sacroiliitis, and thereby determine whether DWI can contribute to the differential diagnosis. Material and Methods A total of 84 patients were included in the study and were separated into three groups: group 1 (13 women, 6 men) comprised cases with brucella positive for sacroiliitis; group 2 (17 women, 19 men) comprised cases negative for brucella but with sacroiliitis; and group 3 (16 women, 13 men) comprised cases negative for brucella and sacroiliitis. Results The mean bone marrow apparent diffusion coefficient (ADC) values independently of edema were determined as 0.71 × 10−3 in sacroiliitis and brucella-positive patients, as 0.53 × 10−3 in brucella-negative and sacroiliitis-positive patients, and as 0.43 × 10−3 in the control group of brucella-negative sacroiliitis-negative patients. In the ADC measurements taken from areas of evident edema in patients with sacroiliitis, the mean values were 0.13 × 10−3 in the brucella-positive group and 0.12 × 10−3 in the brucella-negative group. Conclusion By adding DWI, which is a rapid MR sequence, to sacroiliac joint MR examination, normal bone marrow and bone marrow with sacroiliitis can be objectively differentiated with ADC measurements in addition to visual evaluation.

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Magnetic resonance imaging of pelvic organ prolapse

Abdominal Imaging ◽

10.1007/s00261-001-0137-1 ◽

2002 ◽

Vol 27 (6) ◽

pp. 660-673 ◽

Cited By ~ 14

Author(s):

H. K. Pannu

Keyword(s):

Magnetic Resonance Imaging ◽

Pelvic Organ Prolapse ◽

Magnetic Resonance ◽

Pelvic Organ ◽

Resonance Imaging

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Sexual Dimorphism in Laryngeal Volumetric Measurements Using Magnetic Resonance Imaging

Ear Nose & Throat Journal ◽

10.1177/0145561319840568 ◽

2019 ◽

Vol 99 (2) ◽

pp. 132-136 ◽

Cited By ~ 1

Author(s):

Abdul-Latif Hamdan ◽

Elie Khalifee ◽

Georges Ziade ◽

Sahar Semaan

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Statistical Significance ◽

Resonance Imaging ◽

Men And Women ◽

Mean Width ◽

Significant Difference ◽

The Mean ◽

The Right ◽

Volumetric Measurements

The objective of this study is to investigate the dimensional and volumetric measurements in the thyroarytenoid (TA) muscle in men and women using magnetic resonance imaging (MRI). The hypothesis is that there is a gender-related difference in these measurements. A retrospective chart review of 76 patients who underwent MRI of the neck at the American University of Beirut Medical Center was conducted. The dimension and volume of the right and left TA muscle were measured on axial and coronal planes short tau inversion recovery images. Male and female groups were compared with respect to demographic data and MRI findings using parametric and nonparametric tests. The mean length of the thyro-arytenoid muscle in males was larger than that in females on the right (males 2.44 [0.29] cm vs females 1.70 [0.22] cm) and on the left (males 2.50 [0.28] cm vs females 1.72 [0.24] cm) reaching statistical significance ( P < .001). The mean width of the thyro-arytenoid muscle in males was larger than that in females on the right (males 0.68 [0.13] cm vs females 0.59 [0.11] cm) and on the left (males 0.68 [0.12] cm vs females 0.57 [0.12] cm) reaching statistical significance ( P < .001). The mean height of the thyro-arytenoid muscle in males was larger than that in females on the right (males 1.05 [0.21] cm vs females 0.95 [0.12] cm) and on the left (males 1.05 [0.21] cm vs females 0.95 [0.12] cm) reaching statistical significance ( P < .01 on the right and P < .05 on the left). The volume of the thyroarytenoid muscle in males was larger than that in females on the right (males 0.86 [0.25] mL vs females 0.48 [0.15] mL) and on the left (males 0.89 [0.27] mL vs females 0.48 [0.17] mL) reaching statistical significance ( P < .001). The results of this investigation clearly indicate a significant difference in these measurements between men and women.

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