盆腔器官脱垂的动态MRI研究进展

Dynamic magnetic resonance imaging of pelvic organ prolapse: recent research progress

盆腔器官脱垂(pelvic organ prolapse,POP)是指由于盆底支持结构薄弱导致的盆腔器官疝出.动态MRI为无放射性、无创、快捷、全面、高分辨率的检查方法,其软组织对比性强,可清晰显示静息位及动态位时盆底肌肉和筋膜组织结构及功能上的变化,了解盆腔多组织器官的状况,为临床提供客观影像学数据.动态MRI常用于膀胱脱垂与膨出、子宫和阴道脱垂、直肠脱垂及肠疝的诊断,有多种检查技术和方法.目前国内还没有统一的POP诊断的影像标准,其诊断多参照美国UCLA的标准,采取HMO分度系统,但是否适合于我国人种,尚需进一步探讨.总之,动态MRI可综合评价盆腔器官脱垂,是研究活体盆底解剖、形态和运动的重要方法;特别是动态MRI结合排粪造影术,除了临床评价外,对指导盆底功能障碍性疾病的跨学科治疗也具有一定作用.

Pelvic organ prolapse （POP） refers to herniation of pelvic organs caused by the weak pelvic floor support structures. Magnetic resonance imaging （MRI） is a non-radioactive, non-invasive, fast, comprehensive, high-resolution imaging technique that has strong soft tissue contrast and can clearly show the changes of muscles and fascia structures of pelvic floor to the resting and dynamic position. It can help understand the state of pelvic organizations and provide objective imaging data for the clinical diagnosis. Dynamic MRI is commonly used for the diagnosis of blad- der prolapse and swelling, uterine and vaginal prolapse, rectal prolapse and enterocele. Currently, there are no unif ied diagnostic criteria for POP in China. Although the US HMO system is frequently used for assessing the degree of POP, it needs to be further explored whether this system is f it for the Chinese population. In short, dynamic MRI permits a comprehensive evaluation of pelvic organ prolapse. It is an important way to study the living anatomy, shape and movement of pelvic floor. In addition to clinical evaluations, dynamic MRI （especially dynamic MRI defecography） plays a role in guiding the interdisciplin- ary treatment of pelvic floor dysfunction.