Diagnostic value of MRI in females with stress urinary incontinence

Abstract

Objective To discuss the diagnostic value of MRI in female patients with stress urinary incontinence (SUI). Methods All SUI patients underwent pelvic MRI examination.The 16 patients mean age was 58 years (range,48 -66 years),disease course was 6 years (range,2 -15 years).All patients underwent transobturator tension-free tape (TOT) procedures.The 28 volunteers with no pelvic diseases were set as control,Mean age was 45 years (range,30 -55 years). Results 28 Volunteers' urethral support ligaments appeared as low signal intensity broad linear structures in both T1 WI and T2WI images.Display rate:periurethral ligament was 89％ (25 cases) ; paraurethral ligament was 75％ (21 cases),unilateral 25％ (7 cases) ; pubourethral ligament,in each distal 100％ (near,28 cases),10％ (medium,3 cases),7％ (distal,2 cases); suburethral ligament was 100％ (28 cases). Levator ani muscle in T1WI,T2WI showed Moderate- intensity signal and the display rate was 100％.16 SUI patients showed varyious degrees of laxity and rupture of urethral supporting ligaments which occurred in one group (4 cases) or multi-group (12 cases) ligaments.The ligament laxity showed that periurethral ligament 14 cases,paraurethral ligament 2 cases and proximal pubourethral ligament 10 cases.The ligament rupture was seen in periurethral ligament 2 cases,paraurethral ligament 5 cases,pubourethral ligament 6 cases and suburethral ligament 7 cases.16 patients showed a relaxation of the levator ani muscle changes,including 4 cases with cervical and vaginal wall prolapsed. Conclusions MRI could clearly show the weak of support structures around the urethra in female SUI patients,and showed the cervical and vaginal prolapsed.Therefore,MRI may provide imaging evidence for clinical diagnosis and treatment. Key words: Urethral supporting ligament; Levator ani muscle; Urinary incontinence, stress ; Magnetic resonance imaging