Shui Wen, Luo Yijia, Ying Tao, Li Qin, Dou Chaoran, Zhou Minzhi
Department of Ultrasound in Medicine, Shanghai Institute of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
Medical Imaging Department, Shanghai Jiahui International Hospital, 689 Guiping Road, Shanghai, 200233, China.
Int Urogynecol J. 2020 Jan;31(1):149-154. doi: 10.1007/s00192-019-03946-5. Epub 2019 Apr 11.
To explore the feasibility of three-dimensional (3D) transperineal tomographic ultrasound in evaluating pelvic floor support of the urethra in women.
Three-dimensional transperineal ultrasound volume data sets of 50 women with stress urinary incontinence (SUI) and 25 women without SUI were obtained for analysis. Pelvic floor support of the urethra was evaluated by studying the relationship between the urethra and vagina in vaginal cross section and quantified by estimating the urethral depression (UD) rate. The extent of paravaginal support at level II was also evaluated in tomographic ultrasound imaging (TUI) mode in all participants. Two-sample t-test and Mann-Whitney U test were used for statistical analysis.
The extent of paravaginal support at level II showed no difference between the two groups. Posterior depression of the urethra into the anterior vaginal wall was increased in SUI (P < 0.05). When the UD rate value was 0.53 (CI 85%) combined with three continuous "abnormal slices," the maximum Youden Index value (sensitivity 0.82, specificity 0.88) was obtained to screen dysfunctional support of the urethra.
The pelvic floor support of the urethra can be evaluated indirectly by studying the relationship between the urethra and anterior vaginal wall in the vaginal cross section by TUI. The obvious posterior depression of the urethra into the anterior vaginal wall could be indirect evidence of a defect in the support of the urethra.
探讨三维经会阴断层超声评估女性尿道盆底支持功能的可行性。
获取50例压力性尿失禁（SUI）女性和25例无SUI女性的三维经会阴超声容积数据集进行分析。通过研究阴道横断面上尿道与阴道的关系评估尿道的盆底支持功能，并通过估计尿道凹陷（UD）率进行量化。在断层超声成像（TUI）模式下评估所有参与者II级水平的阴道旁支持程度。采用两样本t检验和曼-惠特尼U检验进行统计分析。
两组II级水平的阴道旁支持程度无差异。SUI患者尿道向后陷入阴道前壁的程度增加（P < 0.05）。当UD率值为0.53（CI 85%）并结合三个连续的“异常切片”时，获得最大约登指数值（敏感性0.82，特异性0.88）以筛查尿道支持功能障碍。
通过TUI研究阴道横断面上尿道与阴道前壁的关系可间接评估尿道的盆底支持功能。尿道明显向后陷入阴道前壁可能是尿道支持缺陷的间接证据。
