How and When to Use MR Imaging of the Female Pelvic Floor

Magnetic resonance imaging of the female pelvic floor has become a routine part of the evaluation of prolapse in a select group of patients, specifically those who present with multi-compartment damage, have failed previous surgery, or have other medical conditions that prohibit a good physical examination. It is also an excellent tool in patients of childbearing age, as there is no radiation exposure to the pelvis. Rapidly acquired T2-weighted images are obtained in the sagittal plane at rest and at maximal strain to identify organ prolapse. Following this, high-resolution axial T2-weighted images are performed to identify muscle tears. Using these images, all three compartments of the pelvic floor can be evaluated simultaneously and a plan can be made for optimal surgical repair.