Fielding J R, Griffiths D J, Versi E, Mulkern R V, Lee M L, Jolesz F A
Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA.
AJR Am J Roentgenol. 1998 Dec;171(6):1607-10. doi: 10.2214/ajr.171.6.9843296.
Our goal was to determine the anatomic differences in pelvic floor anatomy for continent women and women with stress incontinence using MR imaging and to assess whether these anatomic differences depend on the position of the subject during imaging.
Eight continent volunteers and eight women with stress incontinence underwent MR imaging in the supine and sitting positions. For imaging, we used an open-configuration 0.5-T magnet. T2-weighted images were obtained in the midline sagittal plane with subjects at rest and at maximal pelvic floor strain in 5 sec using a modified fast spin-echo sequence. In the axial plane, thin-section T2-weighted images were obtained with subjects at rest using a standard fast spin-echo technique. Images were evaluated for mobility of the urethra and bladder neck and for integrity of the vagina, levator ani, and supporting fascia.
Pelvic floor laxity and abnormalities of the supporting fascia were more common in incontinent women than in continent women. Both descent of the bladder neck when subjects strained and the posterior urethrovesical angle were not significantly greater when subjects were measured in the sitting position (p < .1).
Changes of pelvic floor laxity related to incontinence can be seen with subjects in both the supine and the sitting positions but are increased in the sitting position.
我们的目标是利用磁共振成像确定控尿女性和压力性尿失禁女性盆底解剖结构的差异，并评估这些解剖差异是否取决于成像过程中受试者的体位。
8名控尿志愿者和8名压力性尿失禁女性在仰卧位和坐位接受了磁共振成像检查。成像时，我们使用了开放式0.5-T磁体。采用改良快速自旋回波序列，在受试者静息及5秒内最大盆底张力状态下，于中线矢状面获取T2加权图像。在轴位平面，采用标准快速自旋回波技术，在受试者静息时获取薄层T2加权图像。评估图像中尿道和膀胱颈的活动度以及阴道、肛提肌和支持筋膜的完整性。
盆底松弛和支持筋膜异常在尿失禁女性中比在控尿女性中更常见。当受试者用力时膀胱颈下降以及后尿道膀胱角在坐位测量时均无显著增大（p < 0.1）。
与尿失禁相关的盆底松弛变化在仰卧位和坐位受试者中均可观察到，但在坐位时更为明显。
