Goodrich M A, Webb M J, King B F, Bampton A E, Campeau N G, Riederer S J
Section of Gynecologic Surgery, Mayo Clinic, Rochester, Minnesota.
Obstet Gynecol. 1993 Dec;82(6):883-91.
To evaluate structures involved in pelvic support using conventional and snapshot magnetic resonance imaging (MRI).
We used conventional spin-echo MRI and dynamic snapshot GRASS MRI at various levels of the Valsalva maneuver to describe and quantitate the anatomy of pelvic floor relaxation and to assess anatomical changes produced by surgical repair. Ten female volunteers were evaluated to define normal anatomy and reference measurements. Five women with pelvic floor relaxation were evaluated before and after surgical repair.
Static and dynamic MRI were more sensitive than clinical pelvic examination in assessing and grading pelvic floor relaxation. Quantitative results showed widening of the levator hiatus and more vertical lie of the levator plate postoperatively. Descent of the pelvic organs on maximal straining postoperatively was the same as that in normal volunteers. The posterior urethrovesical angle on MRI was more than 110 degrees in 14 of 15 continent subjects.
Magnetic resonance imaging may be valuable in analyzing and assessing pelvic floor relaxation and in understanding anatomical changes occurring before and after surgical repair. The increased sensitivity of MRI in grading prolapse may make it useful in evaluating women with symptoms of pelvic floor relaxation but who have negative findings on clinical examination.
使用传统及快速成像磁共振成像（MRI）评估参与盆腔支持的结构。
我们在不同瓦尔萨尔瓦动作水平下使用传统自旋回波MRI和动态快速成像稳态梯度回波（GRASS）MRI来描述和量化盆底松弛的解剖结构，并评估手术修复所产生的解剖学变化。对10名女性志愿者进行评估以确定正常解剖结构和参考测量值。对5名盆底松弛的女性在手术修复前后进行评估。
在评估和分级盆底松弛方面，静态和动态MRI比临床盆腔检查更敏感。定量结果显示术后提肌裂孔增宽且提肌板更垂直。术后最大用力时盆腔器官的下移与正常志愿者相同。15名控尿受试者中有14名在MRI上的后尿道膀胱角大于110度。
磁共振成像在分析和评估盆底松弛以及理解手术修复前后发生的解剖学变化方面可能具有重要价值。MRI在分级脱垂方面提高的敏感性可能使其在评估有盆底松弛症状但临床检查结果为阴性的女性时有用。
