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经 3 特斯拉磁共振成像检查的初产妇和经产妇的骨盆测量

Pelvimetry in nulliparous and primiparous women using 3 Tesla magnetic resonance imaging.

机构信息

Department of Obstetrics and Gynecology, Medical School, University of Heidelberg, Heidelberg, Germany.

Radiology Darmstadt, Alice-Hospital, Darmstadt, Germany.

出版信息

Neurourol Urodyn. 2018 Aug;37(6):1950-1956. doi: 10.1002/nau.23537. Epub 2018 Feb 21.

DOI:10.1002/nau.23537
PMID:29464757
Abstract

AIMS

To perform pelvimetry in nulliparous and primiparous women using 3 Tesla magnetic resonance imaging (3T MRI).

METHODS

Twenty-five nulliparous volunteers and 25 primiparous women underwent pelvic 3T MRI within one week after vaginal childbirth in a prospective clinical single-center trial. The pelvimetric parameters interspinous distance (ISD), intertuberous distance (ITD), sagittal outlet (SO), obstetric conjugate (OC), and coccygeal curved length (CCL) were adapted from anthropometric measurements as well as from sonographic and computed tomography-based pelvimetry performed on high-resolution T2-weighted images. We compared the results of the two study groups to one another, recent literature and postpartum-diagnosed levator ani muscle (LAM) injuries.

RESULTS

The mean values for primipara/nullipara were ISD 107 ± 8.3/105 ± 8.4 mm, ITD 119.8 ± 10.2/118.4 ± 13.1 mm, OC 129.4 ± 10/130.8 ± 6.9 mm, SO 114.3 ± 7.8/112.5 ± 8.9 mm, and CCL 37.3 ± 7.4/39 ± 8 mm. Significant differences (P < 0.05) were found between the results for OC, SO, and CCL (primipara) and ISD, ITD and OC (nullipara) and the values in the literature. No significant difference in pelvimetric values was found between the groups. A significant correlation was found between the pelvimetric parameters and five types of LAM injuries.

CONCLUSIONS

Two-dimensional 3T MRI combines high-resolution images with objective pelvimetric measurements applicable in a postpartum setting. Our results provide a good foundation for further MRI-based studies evaluating the bony pelvis and its relation to LAM injuries during vaginal childbirth.

摘要

目的

使用 3 特斯拉磁共振成像(3T MRI)对初产妇和经产妇进行骨盆测量。

方法

在一项前瞻性临床单中心试验中,25 名初产妇志愿者和 25 名经产妇在阴道分娩后一周内接受了盆腔 3T MRI 检查。从人体测量学以及高分辨率 T2 加权图像上进行的超声和计算机断层扫描骨盆测量中,采用了椎间距离(ISD)、骨结节间距离(ITD)、矢状出口(SO)、产科结合径(OC)和尾骨弯曲长度(CCL)等骨盆测量参数。我们将两组研究结果进行了比较,同时还与近期文献和产后诊断的肛提肌(LAM)损伤进行了比较。

结果

初产妇/经产妇的平均 ISD 值分别为 107±8.3/105±8.4mm,ITD 值分别为 119.8±10.2/118.4±13.1mm,OC 值分别为 129.4±10/130.8±6.9mm,SO 值分别为 114.3±7.8/112.5±8.9mm,CCL 值分别为 37.3±7.4/39±8mm。OC、SO 和 CCL(初产妇)与 ISD、ITD 和 OC(经产妇)的结果以及文献中的值之间存在显著差异(P<0.05)。两组之间的骨盆测量值无显著差异。骨盆测量参数与 5 种类型的 LAM 损伤之间存在显著相关性。

结论

二维 3T MRI 结合了高分辨率图像和适用于产后环境的客观骨盆测量。我们的结果为进一步基于 MRI 的研究评估阴道分娩时骨盆的骨性结构及其与 LAM 损伤的关系提供了良好的基础。

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