School of Nursing, University of Michigan, Ann Arbor, MI 48109-5326, USA.
AJR Am J Roentgenol. 2010 Sep;195(3):786-91. doi: 10.2214/AJR.09.3508.
The purpose of this article is to characterize pelvic floor injury after vaginal childbirth with serial MRI.
MR images (3-T) were obtained early (1 month) and late (7 months) after first childbirth in 19 women with risk factors for pelvic floor injury. All women underwent multiplanar intermediate-weighted sequences, and 11 women underwent fluid-sensitive sequences. MR images were evaluated for levator edema and tears and for pubic abnormalities.
Three women had unilateral high-grade tears, three had unilateral low-grade tears, and one had bilateral high- and low-grade tears of the levator ani muscles. All tears were focal at the pubis. Levator edema was present in all women on initial imaging and was resolved at follow-up. Six women had bone marrow edema, five with fracture line. None showed a pattern indicating nerve damage separate from muscle tears.
MRI showed focal levator ani muscle tears at the pubis with bone marrow edema and fracture in patients at risk for pelvic floor injury.
本文旨在通过连续 MRI 对阴道分娩后的盆底损伤进行特征描述。
19 名存在盆底损伤风险因素的初产妇，在分娩后 1 个月（早期）和 7 个月（晚期）时接受了 MRI（3T）检查。所有女性均进行了多平面中等加权序列检查，11 名女性还进行了液体敏感序列检查。MR 图像用于评估提肌水肿和撕裂以及耻骨异常。
3 名女性存在单侧高级别撕裂，3 名女性存在单侧低级别撕裂，1 名女性存在双侧提肌肌肉的高级别和低级别撕裂。所有撕裂均在耻骨处呈局灶性。所有女性在初始成像时均存在提肌水肿，随访时已消退。6 名女性存在骨髓水肿，其中 5 名存在骨折线。均未出现与肌肉撕裂分离的提示神经损伤的模式。
MRI 显示存在盆底损伤风险的患者在耻骨处存在局灶性提肌肌肉撕裂，伴有骨髓水肿和骨折。
