摘要
目的探讨MRI对阴道分娩及盆腔脱垂（POP）后肛提肌功能的量化评估价值。方法选取62例阴道分娩初产妇为观察组，同期行定期体检的40例无分娩史健康女性为对照组。两组均采用GE Signa HD 1.5 T超导型MR扫描仪行静、动态盆底MRI检查，观察两组女性肛提肌的影像学表现，由同组专业医师根据耻骨直肠肌、髂骨尾骨肌图像确定两组肛提肌损伤情况。根据临床病史、体格检查及超声或MRI检查结果，将观察组分为POP组（28例）和正常产妇组（34例）两亚组，通过测量产妇从静息期到最大用力时的H线、肛提肌裂隙面积（LHS）、提肛板角（LPA）和双侧髂骨尾骨角（ICA）等检测指标，量化比较两亚组肛提肌功能的MRI测量指标差异。结果观察组肛提肌损伤占27.42%（17/62），对照组无肛提肌损伤，二者比较差异有统计学意义（P〈0.05）；其中观察组耻骨直肠肌损伤14例，髂骨尾骨肌3例，二者比较差异有统计学意义（P〈0.05）。POP组和正常产妇组静息状态下H线、LPA、LHS、双侧ICA比较差异均未见统计学意义（P〉0.05）；POP组在最大腹压时上述指标分别较正常产妇组、本组静息状态时检测值高，差异均有统计学意义（P〈0.05）。结论阴道分娩后易引起产妇肛提肌损伤并增加POP的发生风险，采用静、动态MRI量化检测能较好评估肛提肌功能形态变化。
Objective To investigate the value of MRI in the quantitative evaluation of the function of levator ani muscle after vaginal delivery and pelvic prolapse （POP）. Methods Sixty-two cases of vaginal delivery primipara were selected as observation group, 40 cases of non pregnancy healthy women in the same period were selected as control group. GE signa HD 1.5 T superconduct MR scanner was used to perform static and dynamic pelvic magnetic resonance imaging （MRI） , the imaging manifestations of levator ani muscle in two groups were observed, the anal muscle injury of two groups were determined by the professional doctors in the same group according to the puborectalis musculus image and the ilioeoccygeus musculus image. According to the clinical history, physical examination and ultrasound or MRI results, the observation group was divided into the POP group （28 cases） and normal pregnancy group （34 cases） , and by measuring maternal H line from the resting period to the maximum force, anus muscle fissure area（ LHS）, levator ani plate angle（ LPA）, bilateral iliococcygeus angle（ICA） and other indexes, quantitative comparison of MRI measurement parameters of levator ani muscle in the two sub- groups was completed. Results The levator ani muscle injury of observation group accounted for 27.42% （17/62） , and the control group had no levator ani muscle injury, the difference was significant （P 〈 0. 05 ）. In observation group, the anal puborectalis muscle injury occurred in 14 cases, ilioeoccygeus muscle occurred in 3 cases, the difference was significant （ P 〈 0. 05 ）. The differences of H line in the resting state, LPA, LHS, bilateral ICA between POP group and normal pregnancy group were not statistically significant （P 〉 0. 05 ） ; Under maximal abdominal pressure, H line in the resting state, LPA, LHS, bilateral ICA of the POP group were higher than those of the normal pregnancy group and the resting state of the POP group, the differences were significant （P 〈 0. 05 �
作者
张峰
Zhang Feng(Department of Radiology, Shanxi Coal Center Hospital, Taiyuan 030006, Chin)
出处
《中国实用医刊》
2017年第19期9-12,共4页
Chinese Journal of Practical Medicine
关键词
磁共振成像
阴道分娩
盆腔脱垂
肛提肌功能
评估价值
Magnetic resonance imaging
Vaginal delivery
Pelvic prolapse
Function of levator ani muscle
Evaluation value
