基于MRI矢状位图像的子宫位置评价研究

Study on the Uterine Position with the Sagittal T_2-weighted MR Images

目的探讨基于MRI矢状位T2WI图像对子宫位置评价的可行性,并对其进行测量和分类。方法选择行盆腔MRI成像的正常中青年女性88例(包括经产妇52例和未产妇36例)。在仰卧位矢状位T2WI上测量阴道轴线与子宫颈轴线的夹角来描述子宫的倾斜方向和程度,测量子宫颈轴线与子宫体轴线的夹角来描述子宫弯曲方向和程度,根据倾斜和弯曲方向进行分类,并比较经产妇和未产妇子宫位置的差别。结果 88例女性子宫平均倾斜(208.8±13.7)°,弯曲(190.2±17.2)°。位置可分为9类,其中前倾位47例,包括前倾不屈6例,前倾前屈23例,前倾后屈18例;平直位31例,包括平直不屈6例,平直前屈4例,平直后屈21例;后倾位10例,包括后倾不屈2例,后倾前屈5例,后倾后屈3例。未产妇子宫平均倾斜(175.8±16.8)°;弯曲(135.8±19.4)°。经产妇平均倾斜(232.8±15.2)°;弯曲(250.2±11.8)°,与未产妇比较两者间存在统计学差异。结论借助MRI矢状位T2WI图像,可以准确的对子宫位置进行测量和分类。在仰卧位矢状面上子宫位置可分为9个类型,未产妇和经产妇的倾斜和弯曲角度存在差异。

Objective To investigate the feasibility of measuring and classifying the uterine position with the sagittal T2 - weighted MR images. Methods The normal pelvic MR images obtained in 88 young and middle - aged women （ muhipara：n = 52 ; nullipara：n = 36） were reviewed. On sagittal T2WI, the included angle between the cervical axis and the vaginal axis was regarded as the tilt direction and degreee of the uterus, the included angle between the cervical axis and the axis of uterine body was measured to describe the bending direction and degree of the uterus. We classified the uterine position basing on the tilt and bending direction of uterus, and compared the difference of uterine position between muhipara and nullipara. Results The uterine position of the 88 women were divided into 9 catego- ries, of which 47 cases were anteverted（6 in the position of anteversion combined with inflextion, 23 in anteversion combined with ante- flexion, 18 in anteversion combined with retroflexion） , 31 cases were straight（6 in strait combined with inflextion, 4 in straight combined with anteflextion, 21 in straight combined with retroflextion）, 10 cases were retroverted （2 in retroversion combined with inflextion, 5 in retroversion combined with anteflexion, 3 in retroversion combined with retroflexion）. The tilt and bending angle were （ 175.8 ± 16.8 ） ° and （135.8 ± 19.4）° in nullipara, （232.8± 15.2）° and （250.2 ± 11.8）° in multipara. There were significant differences between them. Conclusion The uterine position can be accurately measured and classified with sagittal T2 -weighted MR images, which can be divided into 9 categories.