Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Obstetrics and Gynecology, Albany Medical Center, Albany, NY, USA.
Int Urogynecol J. 2022 Jun;33(6):1649-1657. doi: 10.1007/s00192-022-05172-y. Epub 2022 Apr 8.
We present a 3D computational approach for automated clitoral measurements. We hypothesized that computationally derived measurements would be comparable and less variable than reported manual measures.
In this retrospective study, MRIs of 22 nulliparous women age 20-49 years with normal vaginal and clitoral anatomy were collected. Manual segmentations were performed to reconstruct 3D models of the whole clitoris (glans, body, crura, and bulbs) and vagina. The length, width, and volume of the clitoral structures and the distance between the vagina and clitoral structures were calculated. Computed clitoral morphometrics (length, width) were compared to median [range] values from a previously published cadaver study (N = 22) using the median test and Moses extreme reaction test. Calculated distances were compared to mean (± SD) reported by a 2D MRI study (N = 20) using independent t-test and Levene's test.
Overall, computed clitoral morphometrics were similar to manual cadaver measurements, where the majority of length and width measures had ~1-2 mm difference and had less variability (smaller range). All calculated distances were significantly smaller and had smaller SDs than manual 2D MRI values, with two-fold differences in the means and SDs. Large variation was observed in clitoral volumetric measures in our cohort.
The proposed 3D computational method improves the standardization and consistency of clitoral measurements compared to traditional manual approaches. The use of this approach in radiographic studies will give better insight into how clitoral anatomy relates to sexual function and how both are impacted by gynecologic surgery, where outcomes can assist treatment planning.
我们提出了一种用于自动阴蒂测量的 3D 计算方法。我们假设，与报告的手动测量相比，计算得出的测量值更具可比性且更稳定。
在这项回顾性研究中，收集了 22 名年龄在 20 岁至 49 岁之间、具有正常阴道和阴蒂解剖结构的未生育女性的 MRI。手动分割用于重建整个阴蒂（阴蒂头、体、脚和阴蒂球）和阴道的 3D 模型。计算阴蒂结构的长度、宽度和体积，以及阴道和阴蒂结构之间的距离。使用中位数检验和 Moses 极端反应检验，将计算得出的阴蒂形态学（长度、宽度）与之前发表的尸体研究（N=22）的中位数[范围]值进行比较。使用独立 t 检验和 Levene 检验，将计算得出的距离与二维 MRI 研究（N=20）报告的平均值（±SD）进行比较。
总体而言，计算得出的阴蒂形态学与手动尸体测量值相似，其中大多数长度和宽度测量值的差异约为 1-2 毫米，且变异性更小（范围更小）。所有计算得出的距离均明显小于且标准差（SD）小于手动 2D MRI 值，均值和 SD 的差异高达两倍。在我们的队列中，阴蒂体积测量值存在较大差异。
与传统的手动方法相比，所提出的 3D 计算方法可提高阴蒂测量的标准化和一致性。在放射学研究中使用这种方法将更好地了解阴蒂解剖结构与性功能之间的关系，以及两者如何受到妇科手术的影响，从而为治疗计划提供帮助。
