简体中文

论著-头颈部

盆腔器官脱垂手术 前后的MRI动态评估分析

作者:张丽君

所属单位:河南省鹤壁市人民医院CT室 (河南 鹤壁 458030)

PDF

摘要

目的 对比分析盆腔器官脱垂 (pelvic oagan prolapse.POP)患者手 术MRI表现。方法 病例选取科室2012年 9月-2014年9月确诊为POP患者47例作为 POP组,选取同期医院体检正常女性30 例作为对照组,均行静态、动态核磁共 振扫描(MRI),对比2组相关参数值及 POP患者手术前后MRI表现。结果 POP手 术前后静息位提肛肌参数无显著差异(P >0.05),与对照组相比,差异显著(P <0.05);POP手术前后动态位PRT-L、 PRT-R、ICT-L、ICT-R组间对比无差 异(P>0.05),但2组均低于对照组(P <0.05);POP术前动态位LHS、ICA-L、 ICA-R、LPA、M线、H线均显著高于术后 和对照组(P<0.05);术后和对照组差 异显著(P<0.05);手术前后均行MRI扫 描,横断上提肛肌形态无差异,但术后 矢状位上,MRI显示膀胱颈位置上移,膀 胱角度缩小,盆腔器官为最低点位于耻 骨线以上。结论 MRI是POP术前诊断及术 后疗效评估的影像学方式。

Objective To comparatively analyze the MRI findings of patients with pelvic organ prolapse (POP) operation. Methods 47 patients with POP confirmed from September 2012 to September 2014 in the department were treated as the POP group. 30 cases of normal women who received physical examination in the hospital during the same period were selected as the control group. Both of the two groups underwent static and dynamic magnetic resonance imaging (MRI). The related parameter values and MRI findings of POP patients before and after operation were compared between the 2 groups. Results There were no significant differences in resting position levator ani muscle parameters before and after POP operation (P>0.05) and compared with the control group, the differences were significant (P<0.05). There were no significant differences in dynamic PRT-L, PRT-R, ICT-L and ICT-R between groups before and after POP operation (P>0.05) but those in the 2 groups were lower than those in the control group (P<0.05). Before POP operation, dynamic LHS, ICA-L, ICA-R, LPA, M line and H line were significantly higher than those after operation and those in the control group (P <0.05). Compared those after operation with those in the control group, the differences were significant (P<0.05). MRI scanning was performed before and after operation. There were no differences in the morphology of levator ani muscle but for postoperative sagittal view, MRI showed that the position of bladder neck moved up and the bladder angle was reduced. The lowest point of pelvic organ was above the pubic bone line. Conclusion MRI is an imaging method for the diagnosis before POP and postoperative curative effect evaluation.

【关键词】盆腔脏器脱垂;盆底重建手 术;盆腔核磁共振;表现

【中图分类号】R711.3

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2017.05.038

前言

盆腔器官脱垂(POP)是临床常见的盆底功能障碍疾病之一,与支 持盆底器官的肌肉、韧带、筋膜组织松弛造成盆腔器官解剖位置发生 改变有关,中老年女性是疾病的高发人群。据了解,POP的发病率为 6%~56%,且呈逐年上升趋势。目前,手术是临床治疗POP的常见方 式,11%~18%妇女因POP接受手术治疗,但术后主要依据体格检查和 主诉症状评估疗效,存在主观性,无法准确评价盆底结构功能状态, 使得29%的患者反复手术[1]。MRI具有分辨率高、反复检查、操作简便 的特点,可反映盆底功能状态,客观评价治疗效果。对此,本文分析 了POP脱垂手术前后盆腔组织的相关参数值及MRI表现,并与对照组对 比,现报道如下。