Tunn R, Paris S, Fischer W, Hamm B, Kuchinke J
Department of Gynecology and Obstetrics, Charité, Humboldt-Universität zu Berlin, Germany.
Neurourol Urodyn. 1998;17(6):579-89. doi: 10.1002/(sici)1520-6777(1998)17:6<579::aid-nau2>3.0.co;2-r.
In a study, the magnetic resonance imaging (MRI) findings of 69 women were analyzed to define the typical MRI appearance of the pelvic floor musculature in healthy subjects (n = 20) and women with urinary incontinence (UI) and/or genitourinary prolapse (GP) (n = 49). The following parameters were determined: thickness and signal intensity of the levator muscles on each side, distance between the urethra and symphysis, diameter of the proximal urethra, and thickness and configuration of the anterior vaginal wall. These parameters were correlated with the patients' age and parity, urodynamic parameters, and the clinical assessment of the pelvic floor. In contrast to healthy subjects, the frequent findings in women with UI and/or GP are higher signal intensity of the levator muscles (p < 0.05) and loss of the hammock-like configuration of the vagina (p < 0.01). On static MRI, the morphometry of the levator musculature identified no findings typical of either UI or GP. Analysis of MRI combined with patients' parity suggests that the severity of damage to the pelvic floor at delivery is determined by the traumatic event as such and not by the number of deliveries. Urethral diameter, distance of the symphysis to the urethra, and vaginal wall thickness cannot distinguish between controls and women with UI and/or GP. Urodynamic and functional clinical parameters do not correlate with the changes in the pelvic floor musculature demonstrated by static MRI. Although morphological changes in UI and/or GP can be demonstrated by MRI, they can be assigned a pathogenic role only if clinical symptoms are present.
在一项研究中，对69名女性的磁共振成像（MRI）结果进行了分析，以确定健康受试者（n = 20）以及患有尿失禁（UI）和/或泌尿生殖器官脱垂（GP）的女性（n = 49）盆底肌肉组织的典型MRI表现。确定了以下参数：每侧提肌的厚度和信号强度、尿道与耻骨联合之间的距离、近端尿道的直径以及阴道前壁的厚度和形态。这些参数与患者的年龄、产次、尿动力学参数以及盆底的临床评估相关。与健康受试者相比，患有UI和/或GP的女性常见的表现是提肌信号强度较高（p < 0.05）以及阴道失去吊床样形态（p < 0.01）。在静态MRI上，提肌组织的形态测量未发现UI或GP特有的表现。结合患者产次的MRI分析表明，分娩时盆底损伤的严重程度取决于创伤事件本身，而非分娩次数。尿道直径、耻骨联合到尿道的距离以及阴道壁厚度无法区分对照组与患有UI和/或GP的女性。尿动力学和功能性临床参数与静态MRI显示的盆底肌肉组织变化无关。尽管MRI可以显示UI和/或GP的形态学变化，但只有在出现临床症状时才能确定其致病作用。
