摘要
OBJECTIVE:To estimate the role of dynamic magnetic resonance imaging(MRI )as a diagnostic tool in the eval-uation of vaginal apex prolapse in wo men with previous hysterectomy.METHODS:Clinical examinations were performed on 51women presenting wit h symptoms of pro-lapse.A preoperative dynamic MRI assessment was per-formed.The mid pubic line was the reference level used for prolapse grading.The parameters of analysis included 1)correlation by compartments of clin ical and MRI grading of prolapse,2)assessment of the accuracy of clinic al exami-nation of the middle compartment,an d 3)identification of any additional information provided by MRI.AllMRI films were analyzed and validated by the sa me two observers.RESULTS:Analysis of each compartme nt separately re-vealed poor correlation between cli nical and MRI assess-ment Of the 51cases with clinical vau lt prolapse,27(52.9%)cases were clinically overdiagnose d,3(6%)were underdiagnosed,and there was a greement in 21(41.1%)when compared with MRI findings.Postopera-tive follow -up of the 18(85%)patients who underwent colposacropexy after intraoperati ve assessment revealed the presence of cystocele in 4(26.6%)occasions and recto-cele in 3(20%),which had been detected on MRI but not confirmed intraoperatively.CONCLUSION:There is poor correlation between clinical and MRI findings when as-sessing vaginal apex prolapse.Magn etic resonance imaging allows the identification of other p rolapsing compartments and may be a complementary diagnostic tool for the diag-nosis of complex vaginal apex prolap se.
OBJECTIVE:To estimate the role of dynamic magnetic resonance imaging(MRI )as a diagnostic tool in the eval-uation of vaginal apex prolapse in wo men with previous hysterectomy.METHODS:Clinical examinations were performed on 51women presenting wit h symptoms of pro-lapse.A preoperative dynamic MRI assessment was per-formed.The mid pubic line was the reference level used for prolapse grading.The parameters of analysis included 1)correlation by compartments of clin ical and MRI grading of prolapse,2)assessment of the accuracy of clinic al exami-nation of the middle compartment,an d 3)identification of any additional information provided by MRI.AllMRI films were analyzed and validated by the sa me two observers.RESULTS:Analysis of each compartme nt separately re-vealed poor correlation between cli nical and MRI assess-ment Of the 51cases with clinical vau lt prolapse,27(52.9%)cases were clinically overdiagnose d,3(6%)were underdiagnosed,and there was a greement in 21(41.1%)when compared with MRI findings.Postopera-tive follow -up of the 18(85%)patients who underwent colposacropexy after intraoperati ve assessment revealed the presence of cystocele in 4(26.6%)occasions and recto-cele in 3(20%),which had been detected on MRI but not confirmed intraoperatively.CONCLUSION:There is poor correlation between clinical and MRI findings when as-sessing vaginal apex prolapse.Magn etic resonance imaging allows the identification of other p rolapsing compartments and may be a complementary diagnostic tool for the diag-nosis of complex vaginal apex prolap se.
