摘要
目的比较动态磁共振排粪造影和X线排粪造影在出口梗阻型便秘中的诊断价值。方法32例有出口梗阻型便秘临床症状的患者纳入本研究。所有患者均行动态磁共振排粪造影和X线排粪造影检查。磁共振排粪造影序列包括静态高分辨肛管轴位、矢状位和冠状位T2WI序列及动态单层正中矢状位重复采集快速平衡稳态进动序列,分别采集静息、提肛和力排时相图像。X线排粪造影包括前后位静息,侧位静息、提肛、初排和力排时相图像,加摄正中前后位力排相和黏膜相。以耻尾线(PCL)作为参考线,分别在磁共振排粪造影和X线排粪造影图像上测量肛管长、肛直角、肛上距以及可能存在的直肠前突、黏膜脱垂等病变及其程度,以及在磁共振排粪造影图像上测量膀胱颈、子宫颈到耻尾线的距离和可能存在的盆底异常。采用卡方检验比较两种图像显示出口梗阻型便秘及其并发症的情况和严重程度。结果磁共振排粪造影和X线排粪造影在直肠前突、耻骨直肠肌痉挛、小肠疝及乙状结肠疝的诊断方面没有明显的统计学差异(P>0.05)。在显示直肠黏膜脱垂、直肠内套叠和会阴下降方面磁共振排粪造影不及X线排粪造影(P<0.05);而在显示膀胱脱垂、子宫脱垂及其他盆底、盆壁病变方面磁共振排粪造影具有明显优势。结论磁共振排粪造影和X线排粪造影在出口梗阻型便秘诊断方面各有优势,磁共振排粪造影能够提供盆腔脏器及盆底、盆壁形态结构和功能信息,对出口梗阻性便秘同时伴发盆腔多间室病变的全面诊断和整体评估更有帮助。
Objective To compare the diagnostic capabilities of dynamic MR defecography and X-ray defecography in patients with obstructed defecation syndrome （ODS）. Methods 32 consecutive patients with clinical symptoms of ODS underwent both dynamic MR and X-ray defecography of the ano-rectal region within 10 days of each other. Data sets about the condition of ODS and its complication obtained from the two methods were compared using two-tailed chi-square test. Results There was no significant difference in the evacuation phase between MR and X-ray defecography （P＆gt;0.05） for detecting rectocele （13 vs 15）, puborectalis dyssynergia （5 vs 6）, enterocele （1 vs 3）, and sigmoidocele （2 vs 4）. MR defecography was inferior （P〈0.05） to X-ray defecography in the assessment of rectal mucosal prolapse（12 vs 22）,intrarectal invagination （3 vs 18） and descending perineum （8 vs 21）. More complications of the anterior and middle compartment of the pelvic cavity such as cystoptosis and hysteroptosis were demonstrated on MR defecography. Conclusion Dynamic MR defecography and X-ray defecography exhibit different advantages in evaluating ODS. Dynamic MR defecography provides both morphological and functional information for the pelvic floor structures and allows evaluation of the entire pelvis.
出处
《影像诊断与介入放射学》
2015年第1期40-46,共7页
Diagnostic Imaging & Interventional Radiology
基金
广东省科技厅社会发展与基础研究项目(2011A030400003)
产学研合作科技创新平台项目(2012B090600044)
关键词
磁共振成像
X线
排粪造影
出口梗阻型便秘
Magnetic resonance imaging
X-ray
Defecography
Obstructed defecation syndrome
