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Evaluation of the female pelvic floor in pelvic organ prolapse using 3.0-Tesla diffusion tensor imaging and fibre tractography.

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Title: Evaluation of the female pelvic floor in pelvic organ prolapse using 3.0-Tesla diffusion tensor imaging and fibre tractography.
Authors: Zijta FM (AUTHOR), Lakeman MM (AUTHOR), Froeling M (AUTHOR), van der Paardt MP (AUTHOR), Borstlap CS (AUTHOR), Bipat S (AUTHOR), Montauban van Swijndregt AD (AUTHOR), Strijkers GJ (AUTHOR), Roovers JP (AUTHOR), Nederveen AJ (AUTHOR), Stoker J (AUTHOR), Zijta, F M1 (AUTHOR), Lakeman, M M E (AUTHOR), Froeling, M (AUTHOR), van der Paardt, M P (AUTHOR), Borstlap, C S V (AUTHOR), Bipat, S (AUTHOR), Montauban van Swijndregt, A D (AUTHOR), Strijkers, G J (AUTHOR), Roovers, J P (AUTHOR)
Source: European Radiology. Dec2012, Vol. 22 Issue 12, p2806-2813. 8p.
Abstract: Objectives: To prospectively explore the clinical application of diffusion tensor imaging (DTI) and fibre tractography in evaluating the pelvic floor.Methods: Ten patients with pelvic organ prolapse, ten with pelvic floor symptoms and ten asymptomatic women were included. A two-dimensional (2D) spin-echo (SE) echo-planar imaging (EPI) sequence of the pelvic floor was acquired. Offline fibre tractography and morphological analysis of pelvic magnetic resonance imaging (MRI) were performed. Inter-rater agreement for quality assessment of fibre tracking results was evaluated using weighted kappa (κ). From agreed tracking results, eigen values (λ1, λ2, λ3), mean diffusivity (MD) and fractional anisotropy (FA) were calculated. MD and FA values were compared using ANOVA. Inter-rater reliability of DTI parameters was interpreted using the intra-class correlation coefficient (ICC).Results: Substantial inter-rater agreement was found (κ = 0.71 [95% CI 0.63-0.78]). Four anatomical structures were reliably identified. Substantial inter-rater agreement was found for MD and FA (ICC 0.60-0.91). No significant differences between groups were observed for anal sphincter, perineal body and puboperineal muscle. A significant difference in FA was found for internal obturator muscle between the prolapse group and the asymptomatic group (0.27 ± 0.05 vs 0.22 ± 0.03; P = 0.015).Conclusion: DTI with fibre tractography permits identification of part of the clinically relevant pelvic structures. Overall, no significant differences in DTI parameters were found between groups.Key Points: Diffusion tensor MRI offers new insights into female pelvic floor problems. DTI allows 3D visualisation and quantification of female pelvic floor anatomy. DTI parameters from pelvic floor structures can be reliably determined. No significant differences in DTI parameters between groups with/without prolapse. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Evaluation of the female pelvic floor in pelvic organ prolapse using 3.0-Tesla diffusion tensor imaging and fibre tractography.
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  Data: <searchLink fieldCode="AR" term="%22Zijta+FM%22">Zijta FM</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lakeman+MM%22">Lakeman MM</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Froeling+M%22">Froeling M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22van+der+Paardt+MP%22">van der Paardt MP</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Borstlap+CS%22">Borstlap CS</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bipat+S%22">Bipat S</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Montauban+van+Swijndregt+AD%22">Montauban van Swijndregt AD</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Strijkers+GJ%22">Strijkers GJ</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Roovers+JP%22">Roovers JP</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Nederveen+AJ%22">Nederveen AJ</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Stoker+J%22">Stoker J</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Zijta%2C+F+M%22">Zijta, F M</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lakeman%2C+M+M+E%22">Lakeman, M M E</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Froeling%2C+M%22">Froeling, M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22van+der+Paardt%2C+M+P%22">van der Paardt, M P</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Borstlap%2C+C+S+V%22">Borstlap, C S V</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bipat%2C+S%22">Bipat, S</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Montauban+van+Swijndregt%2C+A+D%22">Montauban van Swijndregt, A D</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Strijkers%2C+G+J%22">Strijkers, G J</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Roovers%2C+J+P%22">Roovers, J P</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. Dec2012, Vol. 22 Issue 12, p2806-2813. 8p.
– Name: Abstract
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  Data: <bold>Objectives: </bold>To prospectively explore the clinical application of diffusion tensor imaging (DTI) and fibre tractography in evaluating the pelvic floor.<bold>Methods: </bold>Ten patients with pelvic organ prolapse, ten with pelvic floor symptoms and ten asymptomatic women were included. A two-dimensional (2D) spin-echo (SE) echo-planar imaging (EPI) sequence of the pelvic floor was acquired. Offline fibre tractography and morphological analysis of pelvic magnetic resonance imaging (MRI) were performed. Inter-rater agreement for quality assessment of fibre tracking results was evaluated using weighted kappa (κ). From agreed tracking results, eigen values (λ1, λ2, λ3), mean diffusivity (MD) and fractional anisotropy (FA) were calculated. MD and FA values were compared using ANOVA. Inter-rater reliability of DTI parameters was interpreted using the intra-class correlation coefficient (ICC).<bold>Results: </bold>Substantial inter-rater agreement was found (κ = 0.71 [95% CI 0.63-0.78]). Four anatomical structures were reliably identified. Substantial inter-rater agreement was found for MD and FA (ICC 0.60-0.91). No significant differences between groups were observed for anal sphincter, perineal body and puboperineal muscle. A significant difference in FA was found for internal obturator muscle between the prolapse group and the asymptomatic group (0.27 ± 0.05 vs 0.22 ± 0.03; P = 0.015).<bold>Conclusion: </bold>DTI with fibre tractography permits identification of part of the clinically relevant pelvic structures. Overall, no significant differences in DTI parameters were found between groups.<bold>Key Points: </bold>Diffusion tensor MRI offers new insights into female pelvic floor problems. DTI allows 3D visualisation and quantification of female pelvic floor anatomy. DTI parameters from pelvic floor structures can be reliably determined. No significant differences in DTI parameters between groups with/without prolapse. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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