压力性尿失禁女性患者肛提肌、盆腔内筋膜及尿道的MRI形态学

MRI morphology of the levator ani muscle, endopelvic fascia, and urethra in women with stress urinary incontinence.

作者信息

Tunn Ralf, Goldammer Kathrin, Neymeyer Jörg, Gauruder-Burmester Annett, Hamm Bernd, Beyersdorff Dirk

机构信息

Department of Gynecology and Obstetrics, Charité Medical School, Humboldt-Universität zu Berlin, Germany.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2006 Jun 1;126(2):239-45. doi: 10.1016/j.ejogrb.2005.10.018. Epub 2005 Nov 17.

DOI:10.1016/j.ejogrb.2005.10.018

PMID:16298035

Abstract

OBJECTIVE

To evaluate pathomorphologic changes of the levator ani muscle, endopelvic fascia, and urethra in women with stress urinary incontinence (SUI) by MRI.

STUDY DESIGN

Fifty-four women with SUI were examined by MRI (1.5T): body phased-array coil, axial and coronal proton-density-weighted sequences.

RESULTS

The urethral sphincter muscle showed a reduced thickness of its posterior portion (37%), an omega shape (13%) or higher signal intensity (50%); its abnormal configuration was associated with an increased signal intensity in 70% (p=0.001). The levator ani muscle comprised an unilateral loss of substance in 30%, a higher signal intensity in 28%, and altered origin in 19%. Central defects of the endopelvic fascia were present in 39% (n=21), lateral defects in 46%. There was a significant association between loss of the symphyseal concavity of the anterior vaginal wall and lateral fascial defects (p=0.001) and levator ani changes (p=0.016).

CONCLUSION

MRI yields findings supporting current theories on the pathogenesis of SUI.

摘要

目的

通过磁共振成像（MRI）评估压力性尿失禁（SUI）女性患者肛提肌、盆内筋膜和尿道的病理形态学变化。

研究设计

对54例SUI女性患者进行MRI（1.5T）检查：使用体部相控阵线圈，采用轴向和冠状位质子密度加权序列。

结果

尿道括约肌后部厚度减小（37%），呈ω形（13%）或信号强度增加（50%）；其异常形态与70%的信号强度增加相关（p=0.001）。肛提肌单侧实质缺失占30%，信号强度增加占28%，起始改变占19%。盆内筋膜中央缺损占39%（n=21），外侧缺损占46%。阴道前壁耻骨联合凹陷消失与外侧筋膜缺损（p=0.001）及肛提肌改变（p=0.016）之间存在显著相关性。