Department of Ultrasonography, Xiangya Hospital, Central South University, Changsha 410008.
Department of Gynecology, Xiangya Hospital, Central South University, Changsha 410008, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2023 Aug 28;48(8):1267-1273. doi: 10.11817/j.issn.1672-7347.2023.220577.
Pelvic floor ultrasound can clearly visualize the position and morphology of pelvic floor organs, observe the pelvic organ prolapse in real-time, and quantify and analyze the degree of the levator ani muscle injury, which is the most common imaging method to assess the morphology and function of the levator ani muscle to date. The different ultrasound imaging techniques provide a variety of indicators, each with its own advantages and limitations.Furthermore, two-dimensional ultrasound is the basis of imaging, but it fails to detect cross-sectional images of the pelvic floor; three-dimensional ultrasound can acquire the axial plane of the levator hiatus; tomographic ultrasound imaging allows real-time observation of the levator ani muscle injury; shear wave elastography can provide a quantitative assessment of the contractility and elastic characteristics of the levator ani muscle in real-time. It is of great significance to summarize the basic principles of various ultrasound imaging techniques, summarize the ultrasound image characteristics of levator ani muscle and its hiatus in different populations and different states, and explore the cut-off values and diagnostic criteria-related ultrasound parameters for improving the diagnostic efficiency of pelvic floor ultrasound for levator ani muscle injury, leading to reducing missed diagnosis and misdiagnosis of lesions.
盆底超声能清晰显示盆底器官的位置和形态,实时观察盆腔器官脱垂情况,并对肛提肌损伤的程度进行量化和分析,是目前评估肛提肌形态和功能最常用的影像学方法。不同的超声成像技术提供了多种指标,各有优缺点。此外,二维超声是成像的基础,但无法检测盆底的横断图像;三维超声可以获取肛提肌裂孔的轴向平面;断层超声成像可以实时观察肛提肌损伤;剪切波弹性成像可以实时提供肛提肌收缩性和弹性特征的定量评估。总结各种超声成像技术的基本原理,总结不同人群和不同状态下肛提肌及其裂孔的超声图像特征,探讨提高盆底超声诊断肛提肌损伤诊断效率的相关超声参数的截断值和诊断标准,对于减少对病变的漏诊和误诊具有重要意义。