Practical guide to dynamic pelvic floor MRI

Kobi M1, Flusberg M1, Paroder V2, Chernyak V1. J Magn Reson Imaging. 2018 May;47(5):1155-1170. doi: 10.1002/jmri.25998. Epub 2018 Mar 25.

Author information

1 Department of Radiology, Montefiore Medical Center, Bronx, New York, USA.

2 Department of Radiology, Memorial Sloan Kettering Center, New York, New York, USA.


Pelvic floor dysfunction encompasses a spectrum of functional disorders that result from impairment of the ligaments, fasciae, and muscles supporting the pelvic organs. It is a prevalent disorder that carries a lifetime risk over 10% for undergoing a surgical repair. Pelvic floor weakness presents as a wide range of symptoms, including pain, pelvic pressure or bulging, urinary and fecal incontinence, constipation, and sexual dysfunction. A correct diagnosis by clinical examination alone can be challenging, particularly in cases involving multiple compartments. Magnetic resonance imaging (MRI) allows noninvasive, radiation-free, high soft-tissue resolution evaluation of all three pelvic compartments, and has proved a reliable technique for accurate diagnosis of pelvic floor dysfunction. MR defecography with steady-state sequences allows detailed anatomic and functional evaluation of the pelvic floor. This article provides an overview of normal anatomy and function of the pelvic floor and discusses a practical approach to the evaluation of imaging findings of pelvic floor relaxation, pelvic organ prolapse, fecal incontinence, and obstructed defecation.

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