基于磁共振成像的有和无盆腔器官脱垂女性静息及最大应变状态下阴道前壁位置的三维模型。
Magnetic resonance imaging-based three-dimensional model of anterior vaginal wall position at rest and maximal strain in women with and without prolapse.
作者信息
Larson Kindra A, Hsu Yvonne, Chen Luyun, Ashton-Miller James A, DeLancey John O L
机构信息
Pelvic Floor Research Group, University of Michigan, Ann Arbor, MI, USA.
出版信息
Int Urogynecol J. 2010 Sep;21(9):1103-9. doi: 10.1007/s00192-010-1161-x. Epub 2010 May 7.
INTRODUCTION AND HYPOTHESIS
Two-dimensional magnetic resonance imaging (MRI) demonstrates apical support and vaginal length contribute to anterior wall prolapse (AWP). This paper describes a novel three-dimensional technique to examine the vagina and its relationship to pelvic sidewalls at rest and Valsalva.
METHODS
Twenty women (10 with AWP and 10 with normal support) underwent pelvic magnetic resonance imaging at rest and Valsalva. Three-dimensional reconstructions of the pelvic bones and anterior vaginal wall were created to assess morphologic changes occurring in prolapse.
RESULTS
In women with AWP, Valsalva caused downward translation of the vagina along its length. A transition point separated a proximal region supported by levator muscles and a distal, unsupported region no longer in contact with the perineal body. In this latter region, sagittal and frontal plane "cupping" occurs. The distal vagina rotated inferiorly along an arc centered on the inferior pubis.
CONCLUSION
Downward translation, cupping, and distal rotation are three novel characteristics of AWP demonstrated by this three-dimensional technique.
引言与假设
二维磁共振成像（MRI）显示，顶端支持结构和阴道长度对前壁脱垂（AWP）有影响。本文介绍了一种新颖的三维技术，用于在静息状态和瓦尔萨尔瓦动作时检查阴道及其与骨盆侧壁的关系。
方法
20名女性（10名患有AWP，10名支持结构正常）在静息状态和瓦尔萨尔瓦动作时接受了盆腔磁共振成像检查。对骨盆骨骼和阴道前壁进行三维重建，以评估脱垂时发生的形态学变化。
结果
在患有AWP的女性中，瓦尔萨尔瓦动作导致阴道沿其长度向下移位。一个过渡点将由提肌支持的近端区域和不再与会阴体接触的远端无支持区域分开。在这后一个区域，矢状面和额状面出现“杯状”改变。远端阴道沿以耻骨下为中心的弧线向下旋转。
结论
向下移位、杯状改变和远端旋转是通过这种三维技术所显示的AWP的三个新特征。
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