Contribution of pre- and postoperative MR imaging of the pelvic floor for the morphological analysis of the levator ani in patients with genital prolapse.
Objectives. This study was directed to evaluate the morphological and dynamic aspects of the pelvic floor muscles by the MRI in patients with gynecological prolapse before and after surgery.
Materials and method. MRI had been made before surgical repair in 13 patients with gynecological prolapse, in 9 of this group MRI had been made after the surgery and the group of control was formed by 4 healthy women. We had used morphologic sequences T2 (TSE) and T1 (SE) and fast sequences T2 (TSE) in differents positions: at rest, straining and retention for describe and evaluate the anatomic modification of the levator ani and the changes observed after surgery.
Results. The MRI is able to identify the changes of the levator ani muscles: intrinsic degeneratives lesions, increase of the muscular laxity especially for the puborectalis muscle and the wider of the levator hiatus. After surgical repair, the levator hiatus width and the laxity of the puborectalis muscle are slightly modified during straining.
Conclusion. There are lesions in the muscular structure of the pelvic floor in patients with gynecological prolapse. The MRI was able to analyse these lesions very well especially after the use of fast sequences. The MRI is the future for exhaustive and non invasive study of the static pelvic disorders.
Mots clés : IRM , Plancher pelvien , Prolapsus génital
© 2001 Elsevier Masson SAS. Tous droits réservés.