Tumbarello Julie A, Hsu Yvonne, Lewicky-Gaupp Christina, Rohrer Suzan, DeLancey John O L
Pelvic Floor Research Group, University of Michigan, Ann Arbor, MI, USA.
Int Urogynecol J. 2010 Oct;21(10):1247-51. doi: 10.1007/s00192-010-1178-1. Epub 2010 Jun 11.
This study seeks to quantify differences in anterior vaginal wall prolapse during sequential Valsalva attempts on dynamic magnetic resonance imaging (MRI).
Subjects were taken from an on-going case-control study evaluating anterior vaginal wall prolapse. Women with a prolapse whose leading edge extended >or=1 cm beyond the hymenal ring were included (n = 40). All subjects performed three maximal Valsalva efforts while mid-sagittal dynamic MRI scans were obtained. Bladder descent between the first, second, and third maximal Valsalva efforts were compared.
Forty percent of women had a greater than 2-cm increase in prolapse size from their first to third Valsalva attempt. Ninety-five percent of women extended their prolapse further with a third Valsalva.
As is true during clinical examination, several attempts may be required to have maximal anterior compartment prolapse present during dynamic MRI of the pelvic floor.
本研究旨在通过动态磁共振成像（MRI）对连续瓦尔萨尔瓦动作期间阴道前壁脱垂的差异进行量化。
研究对象来自一项正在进行的评估阴道前壁脱垂的病例对照研究。纳入脱垂前缘超出处女膜环≥1 cm的女性（n = 40）。所有受试者进行三次最大瓦尔萨尔瓦动作，同时获取矢状面动态MRI扫描图像。比较第一次、第二次和第三次最大瓦尔萨尔瓦动作期间膀胱下降情况。
40%的女性从第一次到第三次瓦尔萨尔瓦动作期间脱垂大小增加超过2 cm。95%的女性在第三次瓦尔萨尔瓦动作时脱垂程度进一步加重。
正如临床检查时一样，在盆底动态MRI检查期间，可能需要多次尝试才能使前盆腔最大程度脱垂。
