Study: Dynamic bests static MRI in identifying urethral abnormality

Dynamic MRI allows for the detection of pelvic organ prolapse or displacement within the body that may not be visible on conventional static MRI scans, according to a study published in the December issue of the American Journal of Roentgenology.

Genevieve L. Bennett, MD, assistant professor of radiology, and colleagues at NYU Langone Medical Center in New York City, explained that the purpose of the study was to utilize both static and dynamic MRI in women with a clinically suspected urethral abnormality, and then assessed the findings to learn which scan was more successful in the detection of pelvic organ prolapse.

The study included 84 women who presented with lower urinary tract symptoms. All of the participants involved in the study underwent both dynamic (performed while the patient performs a straining maneuver, such as bearing down) and static (performed while the patient is at rest) MRI scans for suspected urethra abnormality.

"Dynamic imaging allows for the detection of pelvic organ prolapse, which may not be evident at rest but only detected when the woman strains,” proposed Bennett.

After scanning, the images were evaluated by two radiologists for urethral pathology and pelvic organ prolapse.

According to the authors, 11.9 percent of the 84 patients were found to have an abnormality of the urethra.  They found that 39.3 percent were diagnosed with pelvic organ prolapse, of which 87.9 percent were diagnosed exclusively through the use of dynamic imaging.

The study also found that patients with a greater number of vaginal deliveries, stress urinary incontinence, frequency of voiding and voiding difficulty were statistically more likely to have developed pelvic organ prolapse over time.

"The results of our study show that in women with lower urinary tract symptoms who undergo MRI for evaluation of a suspected urethra abnormality, the addition of dynamic MRI permits detection of pelvic organ prolapse that may not be evident on static at rest images and that may also go undetected at physical examination," said Bennett.

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