Department of Obstetrics and Gynecology, Nan Fang Hospital of Southern Medical University, Guangzhou, Guangdong 510515, PR China; Department of Obstetrics and Gynecology, The 3rdAffiliated hospital of Shenzhen University, Shenzhen, Guangdong 518000, PR China.
Department of Obstetrics and Gynecology, Nan Fang Hospital of Southern Medical University, Guangzhou, Guangdong 510515, PR China.
Eur J Obstet Gynecol Reprod Biol. 2018 Sep;228:313-318. doi: 10.1016/j.ejogrb.2018.07.007. Epub 2018 Jul 9.
The aim of this study was to examine if the advanced tool of 3D MRI model provides more precise information on the anatomy of pelvic organs than MRI alone, and compare to clinical and operative finding of patients with vagina in Müllerian duct anomalies.
One hundred and ten patients with clinically and operatively proven Müllerian duct anomalies were included. The consistency of diagnosis of Mullerian tract anomalies by MRI and 3D MRI compared to clinically and surgically proven anomalies defined according to ASRM classification.
We successfully reconstructed retrospectively all 110 patients' three-dimensional models from the simple MRI scans. Eighty-six of the patients (78.2%) showed an agenesis of the uterus, four patients presented with uterine didephys (3.6%). Septate uterus was detectable in 8 of 110 cases (7.3%). Arcuate uterus was detectable in 3 of 110 cases (2.7%). The remaining patients presented with either unilateral (n = 4; 3.6%) or bilateral (n = 5; 4.5%) uterine horns. Reviewed by radiologists, comparing the agreement rate between 3D- MRI reconstruction models and simple MRI, there was a trend towards but not significant difference (P = 0.064). Reviewed by trained surgeons, the agreement between three-dimensional MRI reconstruction models and MRI, there was significant difference (P = 0.003).
3D MRI model is a non-expensive add-on software tool that enhance the ability of expert surgeon to reach a more precise diagnosis of the pelvic anatomy structures, compared to MRI alone. Getting a more precise description of the pelvic anatomy allows a better planning of the corrective procedure needed and preoperative assessment of the expected prognosis.
本研究旨在探讨 3D MRI 模型这一先进工具是否能比 MRI 更准确地提供盆腔器官解剖结构的信息，并与阴道中存在 Müllerian 管畸形患者的临床和手术发现进行比较。
共纳入 110 例经临床和手术证实的 Müllerian 管畸形患者。比较 MRI 和 3D MRI 对 Müllerian 管畸形的诊断一致性，与 ASRM 分类标准下的临床和手术证实的畸形进行比较。
我们成功地从简单的 MRI 扫描中回顾性地重建了所有 110 例患者的三维模型。86 例（78.2%）患者子宫发育不全，4 例患者存在双子宫（3.6%）。8 例（7.3%）可检测到纵隔子宫，3 例（2.7%）可检测到弓形子宫。其余患者单侧（n=4；3.6%）或双侧（n=5；4.5%）子宫角存在。由放射科医生对 3D-MRI 重建模型和简单 MRI 进行评估，发现两者之间存在趋势，但差异无统计学意义（P=0.064）。由训练有素的外科医生对 3D-MRI 重建模型和 MRI 进行评估，两者之间的差异具有统计学意义（P=0.003）。
3D-MRI 模型是一种经济实惠的附加软件工具，可增强专家外科医生对盆腔解剖结构的诊断能力，与单独使用 MRI 相比具有更高的准确性。对盆腔解剖结构进行更精确的描述，可以更好地规划所需的矫正手术，并对预期的预后进行术前评估。
