盆底动态磁共振成像诊断女性压力性尿失禁的临床应用价值

Role of dynamic magnetic resonance imaging in the diagnosis of female stress urinary incontinence

目的探讨盆底动态磁共振成像（MRI）诊断女性压力性尿失禁（SUI）的临床价值。方法SUI患者35例，平均年龄51岁。健康女性30例作为对照组，平均年龄55岁。均行盆底动态MRI检查，分别于静息期及力排期进行快速梯度回波T2加权矢状面扫描，以耻尾线（PCL）作为参照标志，分别测量静息期及力排期膀胱尿道连接部的移动度和膀胱尿道后角以及尿道倾斜角3项指标。统计学分析2组MRI测定指标的差异。结果静息期2组膀胱尿道连接部均位于PCL以上。力排期SUI组膀胱尿道连接部下移距离为（0．9±1．1）cm，对照组为（0．1±0．3）cm，组间差异有统计学意义（P〈0.001）。力排期SUI组膀胱尿道后角为（156±36）°，倾斜角为（65±37）°；对照组分别为（113±28）°，（17±21）°，组间差异均有统计学意义（P〈0.05）。结论盆底动态MRI诊断SUI简单易行，有较大的临床价值。

Objective To evaluate the apphcation of dynamic magnetic resonance imaging in the diagnosis of female stress urinary incontinence （SUI）. Methods Dynamic magnetic resonance imaging （DMRI） were performed on 30 healthy female volunteers and 35 female SUI patients. DMRI of the pelvic floor at rest and on maximal strain were performed by using sagittal T2 weighted fast gradient sequences. The distance of Urethra-vesical junction to the pubococcygeal line, the posterior vesicourethral angle and angle of inclination of the urethral axis were measured at rest and on maximal strain position. The t-value exact test were used to analyze the data. Results At rest the Urethra vesical junction [aid above pubococcygeal line on both control and SUI groups. Mean distance from the Urethra-vesical junction to pubococcygeal line at rest had no difference between the two groups. On straining, the mean Urethra-vesical junction descent distance in the SUI group （-0.9±1. lcm） was significantly higher than in control group （ 0.14 ±0.3 cm）, （P〈0.001）. On straining, the mean angle of urethral inclination in the SUI group （65±37°） was significantly bigger than in control groups （17±21°）,（P〈0.05）. The posterior vesicourethral the SUI groups （156＋36°） was significantly bigger than in control groups （113±28°） , （ P〈0.05 ）. Conclusion Dynamic magnetic resonance imaging is a non-invasive, easily applied method in the diagnosis of SUI.