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MRI of Pelvic Floor Dysfunction: Dynamic True Fast Imaging with Steady-State Precession Versus HASTE

Elizabeth M. Hecht1, Vivian S. Lee1, Teerath Peter Tanpitukpongse1, James S. Babb1, Bachir Taouli1, Samson Wong1, Nirit Rosenblum2, Jamie A. Kanofsky2 and Genevieve L. Bennett1

1 Department of Radiology, New York University Medical Center, 560 First Ave., Ste. HW 202, New York, NY 10016.
2 Department of Urology, New York University Medical Center, New York, NY.


Figure 1
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  		Fig. 1A —52-year-old woman with multicompartmental prolapse. Dashed line corresponds to pubococcygeal line (PCL). Midline sagittal HASTE image obtained at maximal strain reveals mild cystocele, mild urethrocele, moderate urethral hypermobility, moderate vaginal prolapse, moderate cervical prolapse, and severe rectocele.

 

Figure 2
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  		Fig. 1B —52-year-old woman with multicompartmental prolapse. Dashed line corresponds to pubococcygeal line (PCL). Midline sagittal true fast imaging with steady-state precession (FISP) image obtained at maximal strain reveals more severe cystocele and urethrocele than shown on HASTE image (A), urethral hypermobility, vaginal prolapse, and cervical prolapse. Moderate uterine body prolapse is seen exclusively on this sequence.

 

Figure 3
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  		Fig. 2A —44-year-old woman with multicompartmental prolapse. Dashed line corresponds to pubococcygeal line (PCL). Midline sagittal HASTE image obtained at maximal strain reveals mild urethral hypermobility, moderate vaginal prolapse, and severe rectocele.

 

Figure 4
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  		Fig. 2B —44-year-old woman with multicompart mental prolapse. Dashed line corresponds to pubococcygeal line (PCL). Midline sagittal true fast imaging with steady-state precession (FISP) image obtained at maximal strain, however, reveals more moderate degree of urethral hypermobility than shown on HASTE image (A) as well as mild cystocele and cervical prolapse not shown on HASTE images. Note flow-related artifact in bladder. Bladder volume was not significantly changed: 3% increase in volume on true FISP image compared with HASTE image.

 

Figure 5
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  		Fig. 3A —63-year-old woman with multicompartmental prolapse. Dashed line corresponds to pubococcygeal line (PCL). Midline sagittal HASTE image obtained at maximal strain reveals mild cystocele, moderate urethrocele, moderate vaginal prolapse, mild cervical prolapse, and moderate rectal descent.

 

Figure 6
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  		Fig. 3B —63-year-old woman with multicompartmental prolapse. Dashed line corresponds to pubococcygeal line (PCL). Midline sagittal true fast imaging with steady-state precession (FISP) image reveals findings similar to those seen in A; however, only mild urethrocele rather than moderate urethrocele is seen on true FISP image and no cervical prolapse is detected on true FISP image.

 

Figure 7
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  		Fig. 4A —50-year-old woman with multicompartmental prolapse. Dashed line corresponds to pubococcygeal line (PCL). Midline sagittal HASTE image obtained at maximal strain reveals mild cystocele, urethrocele, moderate hypermobility, moderate vaginal prolapse, and moderate rectocele.

 

Figure 8
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  		Fig. 4B —50-year-old woman with multicompartmental prolapse. Dashed line corresponds to pubococcygeal line (PCL). Midline sagittal true fast imaging with steady-state precession (FISP) image reveals more severe cystocele, urethrocele, urethral hypermobility, and rectocele than shown on HASTE image (A). Mild cervical prolapse (arrow) is also seen on true FISP but is not shown on HASTE image.

 

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