摘要
目的对比分析盆底功能障碍性 疾病(pelvic floor dysfunction,PFD) 患者及正常女性盆底解剖结构的MRI表 现。方法 选取我科2012年6月至2014年6 月确诊为PFD的患者40例。同时选取健康 同龄女性志愿者40例作为对照组。通过 行静动态核磁共振扫描(MRI)评价两组 的肛提肌指标、盆腔各器官脱垂情况、 尿道长度和尿道周围支持结构指标。结 果 PFD组耻尾肌面积、髂尾肌面积和耻 直肌面积的静/动态测量值显著低于正常 组。PFD组提肌板角、盆膈裂孔横径、LH 线和M线的静/动态测量值分别为,显著 高于正常组的。PFD组静态和动态期的膀 胱颈、子宫颈和肛直肠连接均显著重于 正常组,P<0.05。结论 PFD患者在MRI所 成图像中盆底解剖结构和正常女性差异 较大,盆腔动静态磁共振在PFD诊断和评 估中具有重要应用价值。
Objective The MRI manifestations of pelvic floor dysfunction (PFD) and normal female in pelvic anatomy were compared. Methods 40 patients diagnosed PFD in our department from June 2012 to June 2014 were selected, including 20 cases of pelvic organ prolapse, urinary incontinence seven cases, the combined 13 cases. Meanwhile 40 healthy female volunteers at the same age were chosen as the control group. By line static and dynamic MRI scans (MRI) evaluation of the levator ani muscle groups indicators pelvic organ prolapse, the urethral length and support structures around the urethra indicators. Results PFD group shame tail muscle area, static / dynamic measurements iliac tail area and shame rectus muscle area were (2.12±0.43) cm2 / (1.76±0.37) cm2 , (1.96±0.55) cm2 / (1.63±0.48) cm2 and (2.29±0.64) cm2 / (1.87±0.53) cm2 , significantly lower than the normal group (2.69±0.57) cm2 / (2.68±0.49) cm2 , (2.43 ±0.61) cm2 / (2.39±0.40) cm2 and (2.77±0.39) cm2 / (2.81±0.36) cm2 . PFD group levator plate angle, pelvic diaphragm hole diameter, LH line and M-line static / dynamic measurement values were significantly higher than the normal group PFD set of static and dynamic phase of the bladder neck, cervix and anorectal connections are significantly focused on the normal group, P<0.05. Conclusion PFD patients have different MRI images in the pelvic floor anatomy with normal female. In pelvic static and dynamic magnetic resonance PFD has important applications in the diagnosis and assessment.
【关键词】盆底功能障碍性疾病;盆底重建;盆腔核磁共振
【中图分类号】R323.3+4
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2015.05.035
前言
女性盆底功能障碍性疾病(pelvic floor dyfunction,PFD)是指盆 底肌肉和其筋膜、韧带、会阴等支持结构发生损坏和功能障碍引起的 疾病,主要包括压力性尿失禁(stress urinary incontinence,SUI)和 盆腔器官脱垂(pelvic organ prolapse,POP)[1]。研究显示[2],我国女 性人群中约有40~46%患有PFD,可见,PFD已经成为影响国人生活质量 和身体健康的重要问题。临床检查和物理检查是PFD常用的诊断措施, 但是临床诊断无法全面评估复杂或者多个部位病变的PFD患者的病情, 即使手术修补也无法完全治愈PFD,其术后复发可能性大,二次手术概 率较大。因此,PFD的精确诊断对提高PFD手术修补效果,降低PFD复发 和二次手术率具有重要作用。磁共振成像(MRI)对肌肉、韧带等软组织 具有较高的分辨率,对PFD的诊断具有重要作用。
中国CT和MRI杂志
第13卷, 第 5 期
2015年05月
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