Hecht Elizabeth M, Lee Vivian S, Tanpitukpongse Teerath Peter, Babb James S, Taouli Bachir, Wong Samson, Rosenblum Nirit, Kanofsky Jamie A, Bennett Genevieve L
Department of Radiology, New York University Medical Center, 560 First Ave., Ste. HW 202, New York, NY 10016, USA.
AJR Am J Roentgenol. 2008 Aug;191(2):352-8. doi: 10.2214/AJR.07.3403.
The objective of our study was to retrospectively compare the degree of pelvic organ prolapse shown on dynamic true fast imaging with steady-state precession (FISP) versus HASTE sequences in symptomatic patients.
Fifty-nine women (mean age, 57 years) with suspected pelvic floor dysfunction underwent MRI using both a sagittal true FISP sequence, acquired continuously during rest alternating with the Valsalva maneuver, and a sagittal HASTE sequence, acquired sequentially at rest and at maximal strain. Data sets were evaluated in random order by two radiologists in consensus using the pubococcygeal line (PCL) as a reference. Measurement of prolapse was based on a numeric grading system indicating severity as follows: no prolapse, 0; mild, 1; moderate, 2; or severe, 3. A comparison between sequences on a per-patient basis was performed using a Wilcoxon's analysis with p < 0.05 considered significant.
Overall, 66.1% (39/59) of patients had more severe prolapse (>or= 1 degrees ) based on dynamic true FISP images, with 28.8% (17/59) of the cases of prolapse seen exclusively on true FISP images. Only 20.3% (12/59) of patients had greater degrees of prolapse on HASTE images than on true FISP images, with 10.2% (6/59) of the cases seen exclusively on HASTE images. A statistically significant increase in the severity of cystoceles (p < 0.01) and urethral hypermobility (p < 0.01)-with a trend toward more severe urethroceles (p < 0.07), vaginal prolapse (p < 0.09), and rectal descent (p < 0.06)-was shown on true FISP images.
Overall, greater degrees of organ prolapse in all three compartments were found with a dynamic true FISP sequence compared with a sequential HASTE sequence. Near real-time continuous imaging with a dynamic true FISP sequence should be included in MR protocols to evaluate pelvic floor dysfunction in addition to dynamic multiplanar HASTE sequences.
我们研究的目的是回顾性比较动态稳态进动快速成像（FISP）序列与快速自旋回波（HASTE）序列在有症状患者中显示的盆腔器官脱垂程度。
59名怀疑有盆底功能障碍的女性（平均年龄57岁）接受了MRI检查，使用矢状面真实FISP序列，在静息期与瓦尔萨尔瓦动作交替时连续采集，以及矢状面HASTE序列，在静息期和最大应变时依次采集。数据集由两名放射科医生以随机顺序进行评估，以耻骨尾骨线（PCL）作为参考达成共识。脱垂的测量基于数字分级系统，严重程度如下：无脱垂为0级；轻度为1级；中度为2级；重度为3级。使用Wilcoxon分析在每位患者的基础上对序列进行比较，p<0.05被认为具有统计学意义。
总体而言，基于动态真实FISP图像，66.1%（39/59）的患者有更严重的脱垂（≥1度），其中28.8%（17/5）的脱垂病例仅在真实FISP图像上可见。只有20.3%（12/59）的患者在HASTE图像上的脱垂程度比在真实FISP图像上更大，其中10.2%（6/59）的病例仅在HASTE图像上可见。真实FISP图像显示膀胱膨出（p<0.01）和尿道活动过度（p<0.01）的严重程度有统计学显著增加，尿道膨出（p<0.07）、阴道脱垂（p<0.09）和直肠下移（p<~0.06）有加重趋势。
总体而言，与顺序性HASTE序列相比，动态真实FISP序列在所有三个腔室中发现的器官脱垂程度更大。除了动态多平面HASTE序列外，MR检查方案中应包括使用动态真实FISP序列进行近实时连续成像，以评估盆底功能障碍。
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