Bauer M, Schulz-Wendtland R, De Gregorio G, Sigmund G
Gynäkologische Radiologie der Radiologischen Universitätsklinik Freiburg.
Geburtshilfe Frauenheilkd. 1992 Jun;52(6):322-6. doi: 10.1055/s-2007-1023759.
Between Oct. 1987 and Oct. 1991 150 patients of the Frauenklinik Freiburg were examined by MR pelvimetry (MRI), 135 of which were "ante partum", i.e. just before delivery. The indications were: earlier operative or strongly protracted delivery, clinical suspicion of disproportion between head and pelvis, or obstetrical "problem pelvis" indicated by manual pelvic examination or ultrasonic foetometry. Previous experimental measurements with a phantom and the comparison with conventional radiograms by Guthmann and Martius of 10 patients in puerperium have shown, that the mean divergence was +/- 2 mm, the maximum divergence 5 mm. The MRI method for pelvimetry "ante partum" or in childbed, proved to be a method of high accuracy and a very good option to judge the pelvic shape, whilst being well accepted by the patients. Furthermore, it allows to determine the foetal BIP (biparietal head-diameter), to judge the pelvic soft-tissue, as well as the visualisation of the birth canal, all without any exposure to radiation. MR pelvimetry is thus part of today's clinical routine. The disadvantages are still the high costs as well as the fact, that only few centres have access to MRI equipment. Nevertheless, the pelvimetry "post partum" can be safely practised radiologically due to the very low radiation exposure.
1987年10月至1991年10月期间,弗莱堡妇科诊所对150例患者进行了磁共振骨盆测量(MRI)检查,其中135例为“产前”检查,即在临产前进行。检查指征包括:既往有手术史或分娩过程延长、临床怀疑头盆不称、或通过骨盆检查或超声胎儿测量提示存在产科“问题骨盆”。此前用模型进行的实验测量以及与古特曼和马蒂乌斯对10例产后患者的传统X线片比较显示,平均偏差为±2毫米,最大偏差为5毫米。用于“产前”或产褥期骨盆测量的MRI方法被证明是一种高精度的方法,是判断骨盆形态的非常好的选择,同时也很受患者接受。此外,它可以确定胎儿双顶径(BIP),判断盆腔软组织情况,以及显示产道,而且无需任何辐射暴露。因此,磁共振骨盆测量是当今临床常规检查的一部分。其缺点仍然是成本高昂,以及只有少数中心能够使用MRI设备。不过,由于辐射暴露极低,产后骨盆测量可以安全地通过放射学方法进行。