磁共振成像对女性重度盆腔器官脱垂患者子宫骶主韧带数字化三维重建模型的量化研究

Quantitative study of magnetic resonance imaging digital three-dimensional reconstruction model in uterosacral ligament and cardinal ligament of female patients with severe pelvic organ prolapse

目的通过磁共振成像（MRI）技术,构建女性重度盆腔器官脱垂（POP）患者子宫骶韧带（USL）和主韧带（CL）的数字化三维重建模型,探讨两种韧带主要MRI测量参数的临床意义。方法选择Ⅲ~Ⅳ期女性POP患者26例为脱垂组,健康女性志愿者18例为对照组,对两组进行盆腔MRI检查,分别测量并比较两组左右侧骶主韧带的位置、起止点距离、宽度、厚度、体积、信号强度（SI）、曲率及USL之间角度、CL之间角度、同侧骶主韧带角度等参数的变化。结果与对照组比较,脱垂组双侧USL均相对于坐骨棘水平发生位置下移（P〈0.05）;双侧USL的SI均低于对照组（P〈0.05）。与对照组比较,双侧CL相对于弓状韧带的位置显著后移（P〈0.05）;双侧CL曲率均大于对照组（P〈0.05）。脱垂组双侧骶主韧带角度均大于对照组（P〈0.05）。轻度和重度子宫脱垂（UP）组中左侧及右侧USL信号强度比较,差异均有统计学意义（P〈0.05）,且均与UP程度呈负相关（r左=-0.431,P=0.028;r右=-0.420,P=0.032）。结论通过MRI测量USL信号强度将进一步辅助量化诊断UP。USL及CL的起始位置、USL信号强度、CL曲率及骶主韧带角度可以作为重度盆腔器官脱垂的MRI测量参数。

Objective To reconstruct three-dimensional model in uterosacral ligaments（USL）and cardinal ligaments（CL）of patients with severe pelvic organ prolapse by magnetic resonance imaging technology,to establish the digital and to investigate the two ligament MRI major measurement parameter.Methods 26 female patients with diagnosed stageⅢ~Ⅳ pelvic organ prolapse（POP）and 18 healthy female volunteers were received pelvic MRI examination.Parameters between the two groups including the position of bilateral USL and CL,the starting and ending point distance,width,thickness,volume,signal intensity,the curvature,the angle between USL,the angle between CL,and the angle between two ligament were compared.Results Compared with the control group,the bilateral USL in POP group was occurred position down relative to the ischial spine levels（P〈0.05）,the right USL was greater than the left（P〈0.05）.Bilateral USL signal intensity in POP group were all lower than that in the control group（P〈0.05）,and the right USL curvature was larger than that of the control（P〈0.05）.Compared with the control group,bilateral CL relative to the position of the arcuate ligament significant backward（P〈0.05）;bilateral CL curvature were higher than the control group（P〈0.05）;bilateral angle between USL and CL was bigger than that of the control group（P〈0.05）.Comparison of light and severe uterine prolapse（UP）group,left and right USL signal intensity differences was all statistically significant（P〈0.05）,and the left and right signal intensity of USL and UP level was a moderate negative correlation（rL=-0.431,P=0.028;rR =-0.420,P=0.032）.Conclusions Measured the signal intensity of USL by the MRI will further assist the quantitative diagnosis of UP,the initial position of USL and CL,the signal intensity of USL,CL curvature,the angle between USL and CL are important MRI measurement parameter of severe pelvic organ prolapse.