Pelvimetry using magnetic resonance imaging. Comparison with X-ray pelvimetry

To evaluate the diagnostic value of magnetic resonance pelvimetry (MRP) in pregnant women at term in comparison with X-ray pelvimetry (X-P). The basic experiment revealed the accuracy of MRP to be satisfactory. Then MRP was performed in thirty-two pregnant women at term (27 with breech presentation and 5 with cephalic presentation) and five non-pregnant patients. Twenty-seven of the pregnant women and all of the non-pregnant patients had X-P simultaneously. Measured MRP and X-P pelvic diameters were compared. Measured diameters of the pelvic inlet (auteroposterior and transverse) were nearly the same with MRP and X-P. But the outlet antero-posterior diameters measured by MRP were smaller than those measured by X-P in twenty-five of twenty-seven women, by an average of 1.0 cm (p<0.001). This gap may result from the difference in posture during examination by means of MRP (supine) and X-P (standing, for lateral image). MRP may represent the actual state of pelvic outlet of women during labor on delivery tables or beds. Vaginal delivery was planned for 22 women with breech presentation who were considered to have an adequate pelvis. Eighteen (82%) of them had successful vaginal delivery and the four other patients had a cesarean section (C/S) due to arrest of labor. Three of four women with cephalic presentation who were suspected by MRP to have a contracted pelvis underwent C/S due to cephalopelvic disproportion. MRP may be a promising alternative to conventional X-P, because it can provide accurate measurements without the hazard of ionizing radiation. (author)