盆底功能障碍磁共振分级与临床分级的相关性研究

Study of the Correlation between MRI Staging and Clinical POP-Q Staging in Pelvic Floor Dysfunction

目的:本研究通过磁共振成像(MRI)检查对PFD患者进行严重程度分级,探讨其与临床广泛应用的盆腔器官脱垂分级量表(POP-Q)所得结果的相关性。方法:2011年4月至2012年5月,门诊收集PFD患者15例,行MRI静息相、收缩相和排泄相检查,以耻骨尾骨线(PCL)作为参考,将所得分级结果与临床POP-Q分级结果相关联。结果:配对计数资料的卡方检验结果为前部和中音部.MRI分级与临床POP-Q分级的一致性较好(前部κ=0.438,standard error=0.16;中部κ=0.423,standard error=0.16),而后部MRI分级与临床POP-Q分级的一致性较差(x=0.057,standard error=0.17)。结论:本试验研究表明盆底器官前部和中部MRI分级与临床POP-Q分级的一致性较好,MRI分级今后可能成为临床体检的替代方法。而后部MRI分级与临床POP-Q分级的一致性较差,由于临床分级法对于盆底结构后部脱垂的诊断准确性低,客观性较强的MRI分级方法可能在这部分疾病的诊断中具有前景。

Purpose： The aim of the study was to determine whether magnetic resonance imaging （MRI） reference line for staging pelvic organ by using the pubococcygeal line （PCL） had the highest agreement with clinical staging. Methods： A retrospective study of women with pelvic floor complaints who underwent dynamic pelvic MRI from April 2011 to May 2012 was conducted. Each pelvic compartment （anterior, middle, posterior） on MRI was staged by using PCL lines. Agreement between MRI and clinical staging was estimated. Results： Fifteen women were included. Agreement between clinical and PCL staging was good in the anterior （κ =0.438） and middle part （κ =0.423）, but poor in the posterior part （κ =0.057）. Conclusion： Our study revealed that agreement between clinical and PCL staging was good in the anterior and middle part, this may show that clinical assessment and MR imaging are interchangeable. The agreement between MRI staging and clinical was poor in the posterior part. It seems reasonable to assume that dynamic MR imaging may have advantages over clinical staging in the assessment of posterior compartment prolapse.