MRI评价前中盆腔器官脱垂程度及其病因

MRI assessment of the severity and causes of female pelvic organ prolapse in the anterior and middle compartment

目的观察盆腔器官脱垂(POP)程度与阴道支持Ⅰ、Ⅱ水平筋膜缺陷、肛提肌萎缩或断裂的关系。方法回顾性分析经临床POP-Q评估诊断为POP的51例中老年女性的静态及动态MRI资料。根据POP-Q评价将POP分为轻度和中-重度,比较轻、中-重度前中POP间筋膜缺陷、髂尾肌和耻骨直肠肌萎缩或断裂发生率的差异。结果约10%前中POP患者仅有Ⅰ、Ⅱ水平筋膜缺陷,约30%仅有肛提肌缺陷,约40%二者并存,约20%既无筋膜缺陷又无肛提肌缺陷;与轻度组比较,中-重度膀胱膨出、子宫脱垂组中筋膜缺陷、髂尾肌和耻骨直肠肌萎缩或断裂的比率增高。结论Ⅰ、Ⅱ水平筋膜缺陷和肛提肌萎缩或断裂的发生率与POP程度有关;肛提肌缺陷在POP中起主要作用。

Objective To observe the correlation with vaginal support level I and [[ fascia[ defects, atrophy or rupture of levator an[ muscles and the severity of female pelvic organ prolapse （POP） in the anterior and middle compartments. Meth- otis Static and dynamic MR data of 51 female patients with POP in the anterior and middle compartments were retrospec- tively reviewed. POP was divided into mild and moderate-severe group according to the clinical POP Quantification （POP- Q）. Level ]~ and ]I fascia[ defects, atrophy or rupture of the iliococcygeat muscles and puborectal muscles were compared between mild and moderate-severe POP. Results POP was associated with level I and II fascial defects in 10% of pa- tients, with levator muscle defects in 30 , with both defects in 40 %, whereas without both defects in 20 ~ patients. Pro- portions of presenting level I and II fascial defects, atrophy or rupture of the iliococcygeal muscles and puboreetal muscles of the moderate-severe group were higher than those of the mild group. Conclusion Proportions of level I and II fascial defects and atrophy or rupture of levator an[ muscles are associated with the severity of POP. Levator an[ defects play an important role in the development of POP.