对比观察三种方法诊断肛提肌损伤

Comparison of three methods for diagnosis of levator avulsion

目的评价经阴道触诊、三维容积重建成像和三维断层超声成像（TUI）技术诊断肛提肌撕裂的能力。方法回顾性分析121例女性患者的临床资料。每例患者均接受问诊、经阴道触诊和经会阴三维超声检查。对数据进行三维容积重建，并在离线状态下应用QLab软件进行断层显像，观察三种方法之间的一致性。结果经阴道触诊和两种超声检查技术在诊断肛提肌损伤的一致性为80．5％～87．5％（Cohern＇s Kappa，0．51～0．67）。结论经阴道触诊、经会阴三维容积成像技术及三维断层超声显像技术皆可对肛提肌损伤进行诊断与评估。

Objective To compare the ability of digital palpation, three-dimensional rendered volumes and tomographic ultrasound imaging （TUI） for diagnosis of levator avulsion. Methods Datasets of 121 women were retrospectively ana- lyzed. Each patient underwent an interview, vaginal examination and 3D translabial ultrasound examination. Analysis of the retrieved ultrasound volumes was performed offline by QLab software for assessment of rendered volumes and evalua- tion on multislice imaging. The agreement among three methods was tested. Results The agreement between the findings on palpation and two ultrasonic methods with regard to diagnosis of levator avulsion ranged from 80.5% to 87.5% （Cohens Kappa, 0. 51--0. 67）. Conclusion The digital palpation, three-dimensional rendered volumes and TUI, each of the three methods may be used to document avulsion of the puborectalis muscle.