Shobeiri S Abbas, White Dena, Quiroz Lieschen H, Nihira Mikio A
Obstetrics and Gynecology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Int Urogynecol J. 2012 Aug;23(8):1047-53. doi: 10.1007/s00192-012-1721-3. Epub 2012 Mar 9.
We used direct histologic comparison to validate the use of 3D endovaginal ultrasound (EVUS) as a novel and emerging technology for evaluating the structures found in the anterior and posterior pelvic floor compartments.
A young nulliparous female pelvis specimen was dissected and histologic slides were prepared by making 8-Micron-thick sagittal cuts. The slides were stained with Mallory trichrome and arranged to form large sections encompassing each anterior and posterior sagittal plane. Healthy nulliparous women underwent 3D EVUS to obtain 3D cubes of the anterior and posterior compartments. Two investigators independently evaluated the anterior and posterior midsagittal structures. The investigators mutually viewed the images and calculated urethral and anal sphincter measurements.
Thirty-one nulliparous women underwent 3D EVUS; 77% of the participants were Caucasian, with mean age 31.8 [standard deviation (SD) 5.8] and mean body mass index (BMI) of 28.5 (SD 7.9). The following mean (SD) measurements were obtained: urethral length 36 mm (± 5); striated urogenital sphincter area 0.6 cm(2) (± 0.16); longitudinal and circular smooth muscle area 1.1 cm(2) (± 0.4); urethral complex width 14 mm (± 2); urethral complex area 1.3 cm(2) (± 0.4); internal anal sphincter length 26 mm (± 4); internal anal sphincter thickness 3.2 mm (± 0.8); and rectovaginal septum length 31 mm (± 5). The agreement for visualization of structures was as follows: vesical trigone 96% (κ = 0.65), trigonal ring 94% (κ = 0.8), trigonal plate 84% (κ = 0.6); longitudinal and circular smooth muscle 100%; compressor urethra 97% (κ = 0.85); striated urogenital sphincter 97% (κ = 0.85); rectovaginal septum 100%; internal anal sphincter 100%; external anal sphincter subdivisions 100%.
Three-dimensional EVUS can be used to visualize structures of the anterior and posterior compartments in nullipara.
我们采用直接组织学比较法，以验证三维经阴道超声（3D EVUS）作为一种新兴技术在评估骨盆前、后盆底结构方面的应用。
解剖一具年轻未育女性骨盆标本，制作8微米厚的矢状切片并制备组织学玻片。玻片用马洛里三色染色法染色，并排列成包含每个前、后矢状平面的大片段。健康未育女性接受3D EVUS检查，以获取骨盆前、后腔的三维立方体图像。两名研究人员独立评估前、后正中矢状结构。研究人员共同查看图像并计算尿道和肛门括约肌的测量值。
31名未育女性接受了3D EVUS检查；77%的参与者为白种人，平均年龄31.8岁[标准差（SD）5.8]，平均体重指数（BMI）为28.5（SD 7.9）。获得以下平均（SD）测量值：尿道长度36毫米（±5）；横纹泌尿生殖括约肌面积0.6平方厘米（±0.16）；纵行和环形平滑肌面积1.1平方厘米（±0.4）；尿道复合体宽度14毫米（±2）；尿道复合体面积1.3平方厘米（±0.4）；肛门内括约肌长度26毫米（±4）；肛门内括约肌厚度3.2毫米（±0.8）；直肠阴道隔长度31毫米（±5）。结构可视化的一致性如下：膀胱三角96%（κ=0.65），三角环94%（κ=0.8），三角板84%（κ=0.6）；纵行和环形平滑肌100%；尿道压迫肌97%（κ=0.85）；横纹泌尿生殖括约肌97%（κ=0.85）；直肠阴道隔100%；肛门内括约肌100%；肛门外括约肌亚部100%。
三维经阴道超声可用于观察未育女性骨盆前、后腔的结构。
