Department of Radiology, NYU Langone Medical Center, New York, NY, USA.
Department of Radiology, NYU Langone Medical Center, New York, NY, USA.
Clin Radiol. 2014 Feb;69(2):e71-7. doi: 10.1016/j.crad.2013.09.015. Epub 2013 Nov 26.
To retrospectively evaluate the prevalence of pelvic organ prolapse as an incidental finding on dynamic magnetic resonance imaging (MRI) using two different references lines.
Sixty women with symptoms unrelated to pelvic floor dysfunction who underwent MRI including a dynamic sagittal true fast imaging with steady-state free precession (TrueFISP) sequence during straining were identified. Two radiologists in consensus used the pubococcygeal line (PCL) and mid-pubic line (MPL) to diagnose and grade prolapse in all three pelvic compartments.
Cystocele was absent, mild, moderate, and severe in 88% (53/60), 7% (4/60), 5% (3/60), and 0% (0/60) of patients, respectively, using PCL, versus 78% (47/60), 13% (8/60), 5% (3/60), and 3% (2/60) of patients, respectively, using MPL. Vaginal prolapse was absent, mild, moderate, and severe in 95% (57/60), 5% (3/60), 0% (0/60), and 0% (0/60) of patients, respectively, using PCL, versus 80% (48/60), 17% (10/60), 3% (2/60), and 0% (0/60) of patients, respectively, using MPL. Rectal descent was absent, mild, moderate, and severe in 63% (38/60), 10% (6/60), 23% (14/60), and 3% (2/60) of patients, respectively, using PCL, versus 43% (26/60), 27% (16/60), 27% (16/60), and 3% (2/60) of patients, respectively, using MPL. No enterocele, peritoneocele, or muscular defect was identified. Two percent (1/60) of patients had mild rectocele, 8% (5/60) had abnormal vesico-urethral angle, and 25% (15/60) had abnormal levator plate angle.
In asymptomatic women, dynamic MRI identified the greatest degrees of prolapse in the posterior compartment. The MPL consistently yielded greater frequency of prolapse than the PCL. Findings of pelvic organ prolapse may be observed in asymptomatic patients and are of uncertain significance, requiring correlation with clinical and physical examination findings.
回顾性分析使用两种不同参考线在动态磁共振成像（MRI）中作为偶发发现的盆腔器官脱垂的患病率。
确定了 60 名有与盆底功能障碍无关症状的女性，这些女性在 MRI 检查中进行了包括动态矢状面真实快速成像稳态自由进动（TrueFISP）序列的用力过程。两位放射科医生使用耻骨尾骨线（PCL）和中耻骨线（MPL）一致地诊断和分级所有三个盆腔隔室的脱垂。
使用 PCL，膀胱膨出在 88%（53/60）、7%（4/60）、5%（3/60）和 0%（0/60）的患者中分别为无、轻度、中度和重度，而使用 MPL，分别为 78%（47/60）、13%（8/60）、5%（3/60）和 3%（2/60）。阴道脱垂在使用 PCL 的 95%（57/60）、5%（3/60）、0%（0/60）和 0%（0/60）的患者中分别为无、轻度、中度和重度，而使用 MPL，分别为 80%（48/60）、17%（10/60）、3%（2/60）和 0%（0/60）。直肠下降在使用 PCL 的 63%（38/60）、10%（6/60）、23%（14/60）和 3%（2/60）的患者中分别为无、轻度、中度和重度，而使用 MPL，分别为 43%（26/60）、27%（16/60）、27%（16/60）和 3%（2/60）。没有发现肠膨出、腹膜膨出或肌肉缺陷。2%（1/60）的患者有轻度直肠膨出，8%（5/60）的患者有异常的膀胱尿道角，25%（15/60）的患者有异常的肛提肌板角。
在无症状女性中，动态 MRI 确定了后盆腔中最大程度的脱垂。MPL 比 PCL 更频繁地发现脱垂。在无症状患者中可能观察到盆腔器官脱垂的发现，但意义不确定，需要与临床和体格检查结果相关联。
