[基于三维磁共振成像模型对静息状态下有和没有盆腔器官脱垂的女性肛提肌的比较]

[Comparison of levator ani muscles in three-dimensional MRI-based models in women with and without pelvic organ prolapse at rest].

作者信息

Liu Ping, Chen Ruolan, Chen Chunlin, Chen Lan, Peng Cheng, Huang Lu, Wang Jianping, Tan Huanqing, Liao Kedan, Tang Lian, Wang Yuezhi, Tang Lei, Zhong Shizhen

机构信息

Department of Obstetrics and Gynecology, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China.

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出版信息

Zhonghua Fu Chan Ke Za Zhi. 2015 Jun;50(6):428-33.

PMID:26311550

Abstract

OBJECTIVE

Comparison of the levator ani muscles in three-dimensional (3D) MRI-based models in women with and without pelvic organ prolapse at rest to analyze the morphological characteristics of levator ani muscles in women with POP.

METHODS

Twenty-five women with POP and 22 women with normal pelvic support were selected from Nanfang Hospital of Southern Medical University. Axial, sagittal, and coronal T2-weighted pelvic magnetic resonance scans were obtained with the women in the supine position.The 3D models were reconstructed from the source images. Morphological changes was compared within the two groups of levator ani muscles, and the 3D models were measured to determine the levator ani muscle volume (LVOL), levator plate angle (LPA), levator hiatus width (LH-W) and length (LH-L), distance between symphysis and levator sling muscle (LSG).

RESULTS

There were no puborectalis avulsions in control, in POP, 3 cases of avulsions just in left, 3 cases of avulsions just in right, 7 cases in bilateral. The shape of iliococcygeus were all dome-shaped in control, 11 cases were U-shaped and 14 cases were dome-shaped in POP. The shape of levator hiatus were 7 cases of U-shape, 12 cases of V-shape, 3 cases of irregular in control; 5 cases of U-shape, 4 cases of V-shape, 16 cases of irregular in POP. POP versus control: LH-L: (68.0 ± 8.9) versus (61.6 ± 7.2) mm (P < 0.05); LH-W: (41.4 ± 3.9) versus (38.0 ± 3.2) mm (P < 0.05); LSG-L: (29.6 ± 7.4) versus (24.6 ± 3.7) mm (P < 0.05); LSG-R: (28.4 ± 6.8) versus (23.9 ± 3.2) mm (P < 0.05); LPA: (51.0 ± 11.3)° versus (40.6 ± 6.3)° (P < 0.05); LVOL: (23.7 ± 5.8) versus (24.6 ± 5.0) cm³ (P > 0.05).

CONCLUSIONS

It is possible to assess the morphologic changes of levator ani by using 3D MRI models objectively, our 3D data demonstrate larger in LVOL, LPA, LH-W, LH-L, LSG, and the changes in shape. It is helpful to diagnose and assess the specific situation of patients POP in clinic.

摘要

目的

比较基于三维（3D）磁共振成像（MRI）模型的有和无盆腔器官脱垂女性静息状态下肛提肌的情况，以分析盆腔器官脱垂（POP）女性肛提肌的形态学特征。

方法

从南方医科大学南方医院选取25例盆腔器官脱垂女性和22例盆腔支持正常的女性。让女性仰卧位时进行轴位、矢状位和冠状位T2加权盆腔磁共振扫描。从源图像重建3D模型。比较两组肛提肌的形态变化，并对3D模型进行测量以确定肛提肌体积（LVOL）、肛提板角度（LPA）、肛提裂孔宽度（LH-W）和长度（LH-L）、耻骨联合与提肌吊带肌之间的距离（LSG）。

结果

对照组无耻骨直肠肌撕裂，盆腔器官脱垂组中，仅左侧撕裂3例，仅右侧撕裂3例，双侧撕裂7例。对照组中髂尾肌形状均为圆顶形，盆腔器官脱垂组中11例为U形，14例为圆顶形。对照组中肛提裂孔形状为7例U形、12例V形、3例不规则形；盆腔器官脱垂组中5例U形、4例V形、16例不规则形。盆腔器官脱垂组与对照组比较：LH-L：（68.0±8.9）mm对（61.6±7.2）mm（P<0.05）；LH-W：（41.4±3.9）mm对（38.0±3.2）mm（P<0.05）；LSG-L：（29.6±7.4）mm对（24.6±3.7）mm（P<0.05）；LSG-R：（28.4±6.8）mm对（23.9±3.2）mm（P<0.05）；LPA：（51.0±11.3）°对（4