Abstract

Purpose

Pelvic organ prolapse (POP) is assessed differently by gynecologists and radiologists. It is clinically staged by physical examination using the POP-Q (Pelvic Organ Prolapse Quantification) system and radiologically staged by modalities such as by Magnetic Resonance Defecography (MRD). The purpose of this study was to correlate the two methods of staging pelvic organ prolapse for each pelvic compartment by comparing correlative anatomic points and differences in technique. This understanding will help synthesize information from two different perspectives and bridge the gap between multiple specialists who participate in the care of patients with complex pelvic floor disorders.

Methods

A retrospective single institution study comparison of patients who underwent both dynamic magnetic resonance pelvic floor imaging and pelvic organ prolapse quantification (POP-Q) at our medical center was done. Two urogynecologists performed the POP-Q and one fellowship-trained radiologist interpreted the MRD and both staged pelvic organ prolapse independently.

Results

A total of 280 patients underwent magnetic resonance imaging (MRI) of the pelvic floor from 1/2013 to 12/2017, of whom 68 met our inclusion criteria. When compared to POP-Q, MRI has strong, moderate, and weak correlation for quantification of anterior, middle, and posterior compartment prolapse, respectively. POP-Q measurements Aa, Ba, C, and D are analogous to true pelvic anatomical landmarks which are directly and consistently measurable by MRI, hence accounting for the better correlation in anterior and middle compartments when compared to measurements Ap and Bp which do not correlate with true anatomical landmarks, and hence can explain the weak correlation for posterior compartment prolapse.

Conclusion

When comparing POP-Q to MRI, anterior and middle compartment prolapse have better correlation than posterior compartment prolapse. Inherent differences that exist in technique and anatomic landmarks used for staging pelvic organ prolapse by clinical exam and imaging criteria account for this. MRD, however, still provides anatomic details on static images, real time simultaneous overview of multi-compartmental prolapse, characterizes contents of cul-de-sac hernias and rectal evacuation on dynamic imaging. Corroborative information derived from both methods of staging organ will result in optimum patient care.

中文翻译：

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MR粪便造影对骨盆底成像：与妇科盆腔器官脱垂量化的相关性。

摘要

目的

妇科医生和放射科医生对盆腔器官脱垂（POP）的评估不同。它在临床上通过使用POP-Q（盆腔器官脱垂量化）系统的体格检查进行分期，并在放射学上通过磁共振波谱仪（MRD）等方式进行分期。这项研究的目的是通过比较相关的解剖学点和技术上的差异，关联两种方法对每个盆腔区进行盆腔器官脱垂的方法。这种理解将有助于从两个不同的角度综合信息，并弥合参与复杂骨盆底疾病患者护理的多位专家之间的鸿沟。

方法

在我们的医疗中心对接受动态磁共振骨盆底成像和骨盆器官脱垂量化（POP-Q）的患者进行了一项回顾性单机构研究比较。两名泌尿科妇科医生进行了POP-Q检查，一名经过研究金培训的放射科医生对MRD进行了解释，并且两人都独立进行了盆腔器官脱垂。

结果

从1/2013至12/2017，共280例患者接受了骨盆底磁共振成像（MRI）检查，其中68例符合我们的纳入标准。与POP-Q相比，MRI在量化前房，中房和后房脱垂时分别具有强，中和弱相关性。POP-Q测量值Aa，Ba，C和D类似于真实的骨盆解剖标志，可直接通过MRI进行连续测量，因此与不相关的测量值Ap和Bp相比，前房和中隔室的相关性更好具有真实的解剖标志，因此可以解释后房脱垂的弱相关性。

结论

将POP-Q与MRI进行比较时，前房和中房脱垂比后房脱垂具有更好的相关性。通过临床检查和成像标准来分期盆腔器官脱垂的技术和解剖学界线存在固有的差异，这可以解释这一点。然而，MRD仍然提供静态图像的解剖学细节，多室脱垂的实时同步概览，动态影像学上的双盲疝和直肠排空的内容。从两种器官分期方法得出的确证信息将为患者提供最佳护理。