对盆腔器官脱垂（POP）女性患者中耻骨直肠肌在弹性成像上无缺陷的评估。
Evaluation of levator ani with no defect on elastography in women with POP.
作者信息
Xie Meng, Zhang Xuyin, Liu Jia, Ding Jingxin, Ren Yunyun, Hua Keqin
机构信息
Department of Ultrasound, Obstetrics and Gynecology Hospital, Fudan University 128 Shen Yang Road, Shanghai 200090, China ; Department of Ultrasound, Zhong Shan Hospital, Fudan University 180 Feng Lin Road, Shanghai 200032, China.
Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital, Fudan University 128 Shen Yang Road, Shanghai 200090, China.
出版信息
Int J Clin Exp Med. 2015 Jun 15;8(6):10204-12. eCollection 2015.
OBJECTIVE
It is difficult to evaluate the function of levator ani with no defect encountered in routine practice. Elastography is a new adjunct to real-time ultrasound imaging that overlays traditional B-mode imaging with a color graphic representation of tissue elasticity. The aim of this study is to specifically evaluate the function of levator ani with no defect by ES (elastography).
METHODS
This was a prospective, observational study. All patients were examined by MRI and the cases with levator ani defect were excluded. The included cases underwent conventional translabial ultrasound, and then ultrasound ES. A little levator ani were biopsied for immunohistochemistry check in the patients who underwent surgery.
RESULTS
Of the 52 cases with no levator ani defects, 22 had an elastography score of 1, 20 had a score of 2, 8 had a score of 3 and 2 had a score of 4 in levator ani. Cases of ES1 and ES2 were more than ES3 and ES4 (P = 0.004). The immunohistochemistry check indicated that 12 patients who underwent surgery showed weak expression and the other 4 patients showed moderate expression of collagen type I in levator ani, compared with 2 controls showing strong expressions.
CONCLUSIONS
Elastography can assess the change of elasticity function of levator ani though the structure has no defect which was detected by MRI and conventional ultrasound. And probably the change of function of levator ani was earlier than structure abnormity in POP.
目的
在常规实践中，若未发现肛提肌有缺陷，则难以评估其功能。弹性成像技术是实时超声成像的一项新辅助技术，它在传统B模式成像上叠加组织弹性的彩色图形表示。本研究的目的是通过弹性成像技术（ES）专门评估无缺陷的肛提肌功能。
方法
这是一项前瞻性观察性研究。所有患者均接受了MRI检查，排除了肛提肌有缺陷的病例。纳入的病例先进行经阴唇常规超声检查，然后进行超声弹性成像检查。对接受手术的患者取少量肛提肌组织进行免疫组化检查。
结果
在52例无肛提肌缺陷的病例中，肛提肌弹性成像评分为1分的有22例，评分为2分的有20例，评分为3分的有8例，评分为4分的有2例。弹性成像评分为1分和2分的病例多于评分为3分和4分的病例（P = 0.004）。免疫组化检查显示，与2例显示强表达的对照相比，12例接受手术的患者肛提肌中I型胶原呈弱表达，另外4例呈中度表达。
结论
尽管MRI和传统超声未检测到肛提肌结构有缺陷，但弹性成像技术仍可评估其弹性功能的变化。而且在盆腔器官脱垂中，肛提肌功能的改变可能早于结构异常。
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