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  • Title: MRI pelvic landmark angles in the assessment of apical pelvic organ prolapse.
    Author: Ginath S, Garely A, Luchs JS, Shahryarinejad A, Olivera C, Zhou S, Ascher-Walsh C, Condrea A, Brodman M, Vardy M.
    Journal: Arch Gynecol Obstet; 2011 Aug; 284(2):365-70. PubMed ID: 20730542.
    Abstract:
    PURPOSE: The aim of the study was to evaluate the utility of magnetic resonance imaging (MRI) pelvic landmark angles and lines in the assessment of apical vault prolapse. METHODS: Seventeen women were evaluated as part of a prospective surgical trial. Baseline data are presented as a pilot study of the utility of MRI in addition to this evaluation of 6 nulliparous volunteers without prolapse and 11 parous women with symptomatic ≥ stage II uterine prolapse. Each patient underwent assessment for pelvic organ prolapse quantification (POPQ) and pelvic MRI. Pelvic landmark angles and lines were measured. Mann-Whitney Rank sum test and Spearman's Rank order correlation test were used to assess agreement. RESULTS: Women with prolapse had a significantly larger h angle, g angle, and e angle at rest than those without prolapse. Correlation between apical vault descent was measured clinically by POPQ point C with MRI measurements: h angle (r = 0.61, p = 0.01), g angle (r = 0.64, p = 0.005), and e angle (r = 0.62, p = 0.007). CONCLUSION: MRI measurements of pelvic landmark angles reliably differentiate between women with and without uterine prolapse and correlate best with POPQ point C.
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