Hayat S K, Thorp J M, Kuller J A, Brown B D, Semelka R C
University of North Carolina School of Medicine, Chapel Hill 27599-7570, USA.
Int Urogynecol J Pelvic Floor Dysfunct. 1996;7(6):321-4. doi: 10.1007/BF01901107.
Magnetic resonance imaging (MRI) was used to assess anatomical changes in the pelvic floor after childbirth. Six women underwent serial MRI examination within 30 hours and at 1 week, 2 weeks, 6 weeks and 6 months after delivery; 8 additional women were studied only within 30 hours of delivery. T-1 and T-2-weighted images of the pelvis in the transverse and sagittal planes with a 1.5-T MR imager were obtained. In the sagittal section we assessed the urethrovesical angle, urethral length, distance from the symphysis to the proximal and distal vagina, vaginal length, width and length of the sphincters, and the presence of sphincter defects. Axial sections were assessed for sphincter defects for the distance between the symphysis and midurethra, vagina and rectum. Only one parameter (distance between symphysis and distal vagina) changed significantly over time, without a clear trend in direction. Interobserver variation was reasonable (<15%) except for anal canal length, urethral length and distance between symphysis and anus. There were no significant correlations between birthweight and MRI parameters. There was a non-significant association (P = 0.09) between the sole combined sphincter defect and rectal injury, but not with episiotomy or parity. We concluded that it is feasible to determine multiple measurements on MR images to evaluate structures of the pelvic floor.
磁共振成像（MRI）用于评估分娩后盆底的解剖学变化。6名女性在分娩后30小时内以及产后1周、2周、6周和6个月接受了系列MRI检查；另外8名女性仅在分娩后30小时内接受了研究。使用1.5-T MR成像仪获取骨盆在横断位和矢状位的T1加权和T2加权图像。在矢状面，我们评估了尿道膀胱角、尿道长度、耻骨联合至阴道近端和远端的距离、阴道长度、括约肌宽度和长度以及括约肌缺损情况。在横断面评估耻骨联合与尿道中段、阴道与直肠之间的距离有无括约肌缺损。仅一个参数（耻骨联合与阴道远端之间的距离）随时间有显著变化，但无明确的变化趋势。除肛管长度、尿道长度以及耻骨联合与肛门之间的距离外，观察者间差异合理（<15%）。出生体重与MRI参数之间无显著相关性。单纯合并括约肌缺损与直肠损伤之间存在非显著关联（P = 0.09），但与会阴切开术或产次无关。我们得出结论，通过MR图像进行多项测量以评估盆底结构是可行的。
