Vaginal shape at resting pelvic MRI: predictor of pelvic floor weakness?

OBJECTIVE The objective was to determine if alteration in vaginal shape seen on nonstraining pelvic magnetic resonance (MR) scans is associated with pelvic floor weakness. METHODS Two readers classified the shape of the middle third of the vagina on resting T2-weighted axial images as normal or abnormal for 76 women with and without pelvic floor weakness. RESULTS The sensitivity and specificity for diagnosing pelvic floor dysfunction were 84% and 68% for reader A and 41% and 91% for reader B. Interobserver agreement was fair (kappa=0.39). CONCLUSIONS Architectural distortion of vaginal shape on routine pelvic MR imaging may suggest pelvic floor dysfunction but is not diagnostic.

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