Li X M, Zhang L M, Li Y, Zhu Q Y, Zhao C, Fang S B, Yang Z L
Department of Ultrasound, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, Shandong, China.
Department of Ultrasound, Maternity and Child Health Care of Zaozhuang, Jining, 261031, China.
Abdom Radiol (NY). 2022 May;47(5):1873-1880. doi: 10.1007/s00261-022-03478-5. Epub 2022 Mar 15.
This study aimed to quantitatively assess the quality of levator ani muscle (LAM) using shear wave elastography (SWE) and to evaluate the association between the elasticity of LAM and stress urinary incontinence (SUI). The study population included 32 women with SUI and 34 women with normal pelvic support. The thickness of LAM, bladder neck descent (BND), and urethral funneling (UF) were assessed by transperineal ultrasound. LAM elasticity was measured by SWE at rest and during the maximal Valsalva maneuver. Age, menopause, BND, and UF showed a positive correlation with SUI. There was no significant between-group difference in the elastic modulus values of LAM at rest. The thickness of LAM in women with SUI was greater than that in control group at rest and during the maximal Valsalva maneuver (P < 0.001). The elastic modulus values of E and E were significantly increased from rest to the maximal Valsalva maneuver in all participants (56.24 vs 82.43 kPa and 47.92 vs 72.37 kPa, P < 0.001). The change of these variables from rest to the maximal Valsalva maneuver in the control group was more obvious than that in the SUI group (34.09 vs 17.87 kPa and 31.55 vs 16.82 kPa, P < 0.05). The elasticity of LAM, as quantified by SWE, may potentially be used as an index for predicting SUI.
本研究旨在使用剪切波弹性成像（SWE）定量评估肛提肌（LAM）的质量，并评估LAM弹性与压力性尿失禁（SUI）之间的关联。研究人群包括32例SUI女性和34例盆底支持正常的女性。通过经会阴超声评估LAM的厚度、膀胱颈下移（BND）和尿道漏斗形成（UF）。在静息状态和最大瓦尔萨尔瓦动作期间通过SWE测量LAM弹性。年龄、绝经、BND和UF与SUI呈正相关。静息状态下LAM的弹性模量值在组间无显著差异。SUI女性在静息状态和最大瓦尔萨尔瓦动作期间LAM的厚度均大于对照组（P < 0.001）。所有参与者从静息状态到最大瓦尔萨尔瓦动作时E和E的弹性模量值均显著增加（56.24对82.43 kPa和47.92对72.37 kPa，P < 0.001）。对照组从静息状态到最大瓦尔萨尔瓦动作时这些变量的变化比SUI组更明显（34.09对17.87 kPa和31.55对16.82 kPa，P < 0.05）。通过SWE量化的LAM弹性可能潜在地用作预测SUI的指标。
