盆底动态MRI对盆底功能异常的诊断价值

The Diagnostic Value of Dynamic MRI in Pelvic Floor Disfunction

目的使用自行设计高顺应性球囊模拟粪便进行盆底动态MRI检查,评价其可行性、敏感性、稳定性。资料与方法对40例盆底功能失调女性患者(年龄24～79岁,平均56.5岁)在肛管内插入高顺应性球囊前、后分别行盆底动态MRI扫描。并对插入球囊前、后所得检查数据进行比较。结果40例中,诊断膀胱膨出20例(50%)、直肠前膨出29例(72.5%)、外括约肌萎缩16例(40%)、耻骨直肠肌痉挛综合征5例(12.5%)、肛直肠连接异常下降2例(5%)、直肠子宫陷窝疝11例(27.5%)、会阴脱垂9例(22.5%)、内外括约肌放松异常8例(20%)。盆底动态MRI检查过程中,有24例在仰卧位排出球囊。16例未能排出球囊(其中5例改为左侧卧位后排出)。经统计分析,球囊排出者与未排出者,以及同一患者使用球囊前后所得数据间存在明显差异。结论球囊排出患者较未排出者盆底运动要明显,而球囊的使用可明显加大盆底运动幅度,更好地反映盆底运动。

Objective To evaluate the feasibility, sensitivity and stability of dynamic MRI with self-designed high compliance sacculus in diagnosing pelvic floor disfunction. Materials and Methods Forty women （24 -79 years, mean age of 56.5 years） with pelvic floor disfunction were enrolled in this study. Pelvic floor dynamic MRI before and after utilized self-designed high compliance sacculus were compared. Results 24 patients defecated the sacculus, 5 patients of the remainder defecated the sacculus after change position from supine to left lateral. On dynamic MRI, 20 cystocele （50%） , 29 rectocele （72.5%） , 16 external anal sphincter atrophy （40%） , 5 spastic pelvic floor syndrome（ 12.5% ） , 11 rectouterine pouch hernia （27.5 % ）, 9 perineum prolapse （22.5%） were revealed. There were statistical differences between the dynamic MR of patients who defecated and fail to defecated the sacculus. The dynamic MR data in patients before and after utilized sacculus had significant differences. Conclusion Pelvic floor dynamic MR using sacculus has great value in diagnosing pelvic floor disfunction.