Evaluation of two classifications systems for pelvic prolapse on dynamic MRI

Purpose. To determine the Usefulness of two classification systems for pelvic prolapse on MRI. Materials and methods. Prospective study of 30 patients with symptoms of pelvic prolapse performed in a single center. All patients underwent clinical evaluation followed by dynamic pelvic MRI within 15 days. All MR examinations were reviewed by three readers using both classification systems based on different anatomical landmarks. The First used the pubococcygeal line and the second used the midpublic line. Results. For prolapse detection, the correlation between clinical examination and MRI was good to very good, ranging between 74 and 89%. For prolapse staging, the correlation was poor to moderate. Interobserver agreement was good to very good (kappa between 0.67 and 0.95). It was slightly better at the mid stage, with both systems (kappa between 0.83 and 0.97). Comparison of the inter-observer agreement between both MRI classification systems showed better results for the system using the pubococcygeal line (p<0.005). Conclusion. The classification system based on the pubococcygeal line appeared more reliable and simple for the evaluation of pelvic prolapse on MRI.