caa a22 4500 605493596 CHVBK 20210128100521.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00261-015-0476-y doi (NATIONALLICENCE)springer-10.1007/s00261-015-0476-y The value of dynamic magnetic resonance imaging in interdisciplinary treatment of pelvic floor dysfunction [Elektronische Daten] [U. Attenberger, J. Morelli, J. Budjan, A. Herold, P. Kienle, W. Kleine, A. Häcker, C. Baumann, J. Heinzelbecker, S. Schoenberg, H. Michaely] Purpose: The purpose of this study was to determine the value of dynamic pelvic floor MRI relative to standard clinical examinations in treatment decisions made by an interdisciplinary team of specialists in a center for pelvic floor dysfunction. Methods: 60 women were referred for dynamic pelvic floor MRI by an interdisciplinary team of specialists of a pelvic floor center. All patients were clinically examined by an urologist, gynecologist, a proctological, and colorectal surgeon. The specialists assessed individually and in consensus, whether (1) MRI provides important additional information not evident by physical examination and in consensus whether (2) MRI influenced the treatment strategy and/or (3) changed management or the surgical procedure. Results: MRI was rated essential to the treatment decision in 22/50 cases, leading to a treatment change in 13 cases. In 12 cases, an enterocele was diagnosed by MRI but was not detected on physical exam. In 4 cases an enterocele and in 2 cases a rectocele were suspected clinically but not confirmed by MRI. In 4 cases, MRI proved critical in assessment of rectocele size. Vaginal intussusception detected on MRI was likewise missed by gynecologic exam in 1 case. Conclusion: MRI allows diagnosis of clinically occult enteroceles, by comprehensively evaluating the interaction between the pelvic floor and viscera. In nearly half of cases, MRI changed management or the surgical approach relative to the clinical evaluation of an interdisciplinary team. Thus, dynamic pelvic floor MRI represents an essential component of the evaluation for pelvic floor disorders. Springer Science+Business Media New York, 2015 Dynamic pelvic floor MRI nationallicence Pelvic floor dysfunction nationallicence Pelvic floor center nationallicence Rectocele nationallicence Enterocele nationallicence Cystocele nationallicence Attenberger U. Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany aut Morelli J. Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut Budjan J. Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany aut Herold A. Enddarmzentrum, Mannheim, Germany aut Kienle P. Department of Surgery, University Medical Center Mannheim, Heidelberg, Germany aut Kleine W. Department of Gynecology, University Medical Center Mannheim, Heidelberg, Germany aut Häcker A. Department of Urology, University Medical Center Mannheim, Heidelberg, Germany aut Baumann C. Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany aut Heinzelbecker J. Department of Urology, University Medical Center Mannheim, Heidelberg, Germany aut Schoenberg S. Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany aut Michaely H. Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/7(2015-10-01), 2242-2247 0942-8925 40:7<2242 2015 40 261 https://doi.org/10.1007/s00261-015-0476-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-015-0476-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Attenberger U. Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany aut NATIONALLICENCE 700 1- Morelli J. Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut NATIONALLICENCE 700 1- Budjan J. Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany aut NATIONALLICENCE 700 1- Herold A. Enddarmzentrum, Mannheim, Germany aut NATIONALLICENCE 700 1- Kienle P. Department of Surgery, University Medical Center Mannheim, Heidelberg, Germany aut NATIONALLICENCE 700 1- Kleine W. Department of Gynecology, University Medical Center Mannheim, Heidelberg, Germany aut NATIONALLICENCE 700 1- Häcker A. Department of Urology, University Medical Center Mannheim, Heidelberg, Germany aut NATIONALLICENCE 700 1- Baumann C. Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany aut NATIONALLICENCE 700 1- Heinzelbecker J. Department of Urology, University Medical Center Mannheim, Heidelberg, Germany aut NATIONALLICENCE 700 1- Schoenberg S. Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany aut NATIONALLICENCE 700 1- Michaely H. Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/7(2015-10-01), 2242-2247 0942-8925 40:7<2242 2015 40 261