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1.5T Pelvic floor laxity - Vanderbilt University

ExamCard
Arildsen, Ronald Nashville, Vanderbilt University Medical Center
Andal, Ric Nashville, Vanderbilt University Medical Center
Welch, Brian Philips Healthcare

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ExamCard purpose

This ExamCard's primary purpose is to quantitate the degree of pelvic floor laxity.  When prolapse is suspected, this imaging protocol is used for any pelvic floor structure such as uterus, bladder, rectum, etc.  It is also used to look for urethral diverticulum. 

 

The axial images are primarily a survey for anatomic abnormalities (unexpected mass, etc.). The sagittal single shot images with and without straining are very useful for drawing the pubococcygeal line to quantitate descent of organs in the three compartments. With the administration of ultrasound gel per vagina and/or per rectum, rectal abnormalities are better seen (eg. rectocele). In the evaluation for cystocele, the bladder urine is well seen on the T2 SS and balanced FFE. The dynamic weight bearing/relaxation cycle is repeated several times. This graphically shows the laxity.

ExamCard overview

Pelvic Floor Laxity
Scan 1SURVEY
Scan 2Ref_SBC
Scan 3TRA T1W TSE
Scan 4TRA T2W TSE
Scan 5SAG single slice DYN BFFE
Scan 6SAG NON-BEAR
Scan 7SAG BEAR
Scan 8COR NON-BEAR
Scan 9COR BEAR



ExamCard images

T1W TSE T2W TSE DYN BFFE
T1W TSE
T2W TSE
DYN BFFE

SAG NON-BEAR SAG BEAR
SAG NON-BEAR
SAG BEAR
COR NON-BEAR COR BEAR
COR NON-BEAR
COR BEAR

Patient preparation

Instruct patient to slowly bear down and slowly relax (non-bearing) or do the Kegel exercise throughout the one minute dynamic sequence.  This should allow visualization of 2-3 non-bearing and bearing states.

 

If vaginal and/or rectal prolapse is suspected, the vagina or rectum should be filled with ultrasound gel.

 

Do not let the patient empty the bladder just prior to the exam.

 

For the "non-bearing" sequences, just have the patient relax as normal. 

 

For the "bearing" sequences, have the patient bear down and perform a breath hold for the duratrion of the scan.

Contrast agent / injection protocol

I.V. CONTRAST IS NOT NEEDED IN THE DYN_BFFE SEQUENCE.


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Jun 7, 2007

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ExamCard
Achieva 1.5T
Release 1, Release 2
Bladder, Body, Small bowel, Uterus
 

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