Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
Acad Radiol. 2011 Oct;18(10):1245-51. doi: 10.1016/j.acra.2011.05.010. Epub 2011 Jul 26.
The aims of this study were to determine agreement between clinical examination and magnetic resonance imaging (MRI) (rectal contrast and noncontrast MRI) for pelvic organ prolapse using both the pubococcygeal line (PCL) and the midpubic line (MPL) and to assess the relationship between measurements performed relative to each line.
Dynamic MRI exams in 88 women (with rectal contrast, n = 39; noncontrast, n = 49) were evaluated, followed by review of clinical exam notes. Agreement between clinical exam and MRI and the difference between PCL and MPL measurements were evaluated.
Agreement of rectal contrast MRI with clinical exam was 79% for PCL and 85% for MPL (P = .17) for cystoceles, 50% for PCL and 59% for MPL (P = .20) for vaginal prolapse, 56% for PCL for enteroceles, and 61% for rectoceles. Agreement of noncontrast MRI with clinical exam was 67% for PCL and 78% for MPL (P = .19) for cystoceles, 58% for PCL and 71% for MPL (P = .10) for vaginal prolapse, 65% for enteroceles, and 40% for rectoceles. The average difference between the PCL and the MPL was 3.12 ± 0.24 cm at the bladder base and 4.88 ± 0.37 cm at the vaginal apex.
Agreement of MRI with clinical exam was highest for cystoceles. There was no significant difference in agreement using the MPL or PCL, suggesting that either line can be used on MRI. The average differences between the PCL and MPL at the bladder base and vaginal apex were approximately 3 and 5 cm, respectively.
本研究旨在通过会阴肛提肌线（PCL）和耻骨中点线（MPL）比较临床检查和磁共振成像（MRI）（直肠对比和非对比 MRI）在盆腔器官脱垂中的诊断一致性，并评估两种方法之间的相关性。
对 88 名女性（直肠对比 MRI 39 例，非对比 MRI 49 例）进行动态 MRI 检查，然后回顾临床检查记录。评估临床检查和 MRI 之间的一致性以及 PCL 和 MPL 测量值之间的差异。
直肠对比 MRI 与临床检查在膀胱膨出方面的一致性为 PCL 为 79%，MPL 为 85%（P=.17）；阴道膨出方面为 PCL 为 50%，MPL 为 59%（P=.20）；肠膨出方面为 PCL 为 56%，MPL 为 61%；直肠膨出方面为 PCL 为 67%，MPL 为 78%。非对比 MRI 与临床检查在膀胱膨出方面的一致性为 PCL 为 67%，MPL 为 78%（P=.19）；阴道膨出方面为 PCL 为 58%，MPL 为 71%（P=.10）；肠膨出方面为 PCL 为 65%，MPL 为 40%；直肠膨出方面为 PCL 为 40%，MPL 为 71%。PCL 和 MPL 在膀胱底的平均差值为 3.12±0.24cm，在阴道顶点的平均差值为 4.88±0.37cm。
MRI 与临床检查在膀胱膨出方面的一致性最高。使用 MPL 或 PCL 时，其一致性没有显著差异，这表明两种方法都可以在 MRI 上使用。PCL 和 MPL 在膀胱底和阴道顶点的平均差值分别约为 3cm 和 5cm。
