三维超声断层成像对女性肛提肌成像效能性及可重复性的研究

Effectiveness and repeatability of tomographic ultrasound imaging for displaying levator ani muscle in nulliparas

目的从方法学上阐述三维超声断层成像(TUI)技术成像盆底结构的有效性和可重复性,为检查肛提肌和提肌裂孔的形态学改变奠定基础。方法 61例健康未育女性受检者,经会阴三维超声对其检查,采集其盆底三维容积数据,启用TUI分析。在生殖裂孔最小平面测量其前后径、左右径及面积,并在阴道后外侧与肛提肌左右肢长轴径线相垂直处测量肛提肌厚度。间隔3周后,同一医师对所获得的容积数据进行第2次测量。11例受检者在进行两次超声检查2周后接受盆底MRI检查,并与TUI横切面结果对照。结果 TUI可在平行的多个平面同时显示肛提肌的形态。组内测量的相关系数:生殖裂前后径为0.72,左右径为0.78,面积为0.59;肛提肌厚度为0.63。MRI与TUI的测量差异无统计学意义。结论 TUI可以同时在多个平行平面上显示肛提肌的走行、完整性及其与盆壁的连接,以及生殖裂孔的形态。在生殖裂孔径线和肛提肌厚度测量上具有良好的有效性和可重复性,可作为检查盆底肛提肌和生殖裂孔形态学的常规方法。

Objective To explore the effectiveness and repeatability of tomographic ultrasound imaging （TUI）in displaying the pelvic floor structure and provide the basis for the examination of morphological change in levator ani muscle. Methods Sixty normal healthy nulliparous female volunteers were enrolled in this study. Tomographic ultrasound examination was performed and the three-dimensional volume data was collected. The dimensions of the levator hiatus and the thickness of levator ani muscle were measured in the plane of minimal hiatal dimensions. Three weeks later, the measurement was done for the second time. MRI were performed 2 weeks after two times of TUI examination,then the results were compared with TUI. Results Tomographic ultrasound image of a normal pelvic floor represent axial plane slices obtained at a 2.5-mm slice interval. The ICC values of muscle thickness in the plane of minimal hiatal dimensions, transverse diameter of the levator hiatus and anterior posterior diameter were 0.63,0.78 and 0.72, respectively. There was no statistics difference between the results of TUI and MRI. Conclusion The tomographic ultrasound imaging measurement of pubovisceral muscle and levator hiatus is reliable in women with no symptoms of prolapse at rest and during contraction. It may be useful in evaluating the anatomy of the levator ani muscle.