Hsu Yvonne, Chen Luyun, Huebner Markus, Ashton-Miller James A, DeLancey John O L
University of Michigan, Ann Arbor, Michigan, USA.
Obstet Gynecol. 2006 Oct;108(4):879-83. doi: 10.1097/01.AOG.0000233153.75175.34.
Compare levator ani cross-sectional area as a function of prolapse and muscle defect status.
Thirty women with prolapse and 30 women with normal pelvic support were selected from an ongoing case-control study of prolapse. For each of the two groups, 10 women were selected from three categories of levator defect severity: none, minor, and major identified on supine magnetic resonance scans. Using those scans, three-dimensional (3D) models of the levator ani muscles were made using a modeling program (3D Slicer), and cross-sections of the pubic portion were calculated perpendicular to the muscle fiber direction using another program, I-DEAS. An analysis of variance was performed.
The ventral component of the levator muscle of women with major defects had a 36% smaller cross-sectional area, and women with minor defects had a 29% smaller cross-sectional area compared with the women with no defects (P < .001). In the dorsal component, there were significant differences in cross-sectional area according to defect status (P = .03); women with major levator defects had the largest cross-sectional area compared with the other defect groups. For each defect severity category (none, minor, major), there were no significant differences in cross-sectional area between women with and those without prolapse.
Women with visible levator ani defects on magnetic resonance imaging had significantly smaller cross-sectional areas in the ventral component of the pubic portion of the muscle compared with women with intact muscles. Women with major levator ani defects had larger cross-sectional areas in the dorsal component than women with minor or no defects.
II-2.
比较肛提肌横截面积与脱垂及肌肉缺损状态之间的关系。
从一项正在进行的脱垂病例对照研究中选取30例有脱垂的女性和30例盆底支持正常的女性。对于两组中的每一组,从仰卧位磁共振扫描确定的肛提肌缺损严重程度的三个类别中各选取10名女性:无、轻度和重度。利用这些扫描图像,使用建模程序(3D Slicer)制作肛提肌的三维(3D)模型,并使用另一个程序I-DEAS计算垂直于肌纤维方向的耻骨部分的横截面积。进行方差分析。
与无缺损的女性相比,重度缺损女性的肛提肌腹侧部分横截面积小36%,轻度缺损女性的横截面积小29%(P < .001)。在背侧部分,根据缺损状态横截面积存在显著差异(P = .03);与其他缺损组相比,重度肛提肌缺损的女性横截面积最大。对于每个缺损严重程度类别(无、轻度、重度),有脱垂和无脱垂女性的横截面积无显著差异。
与肌肉完整的女性相比磁共振成像显示有明显肛提肌缺损的女性肌肉耻骨部分腹侧的横截面积明显更小。重度肛提肌缺损的女性背侧部分的横截面积比轻度缺损或无缺损的女性更大。
II-2