MRI of the Pelvic Floor

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Key Points

The pelvic floor is a complex anatomic and functional unit. Over the past few years MR imaging has gained increasing acceptance as imaging modality for evaluation of the pelvic floor. Using static T2-weighted sequences, the morphology of the pelvic floor can be visualized in great detail. A multicoil array and a rapid half-Fourier T2-weighted, balanced steady-state free precession (bSSFP), or gradient-recalled echo (GRE) sequence are used to obtain sagittal images while the patient is at rest, during pelvic squeeze, during pelvic strain, and to document the evacuation process. On these images the radiologist identifies the pubococcygeal line (which represents the level of the pelvic floor) and the H- and M-Lines (which are helpful for confirming pelvic laxity). Based on these static and dynamic MR imaging sequences, a vast array of morphologic and functional pelvic floor disorders can be depicted.