MRI在产后盆底功能障碍早期评估中的应用

Application of MRI in the Early Evaluation of Postpartum Pelvic Floor Dysfunction

目的探讨磁共振成像(MRI)在产后盆底功能障碍早期评估中的应用。方法选择医院2016年3月-2018年3月收治的产后盆底功能障碍产妇80例作为观察组,另选择同时期产后盆底功能正常的产妇80例作为对照组,两组均接受MRI扫描,对比两组产妇静态和动态下影像特点。结果在MRI扫描静态和动态下,观察组的髂骨尾骨肌、耻骨尾骨肌、耻骨直肠肌面积均小于对照组(P<0.05)。观察组的横断位肛提肌裂孔宽度、矢状位耻骨联合到肛直肠连接后缘的连线(LH线)、直肠后壁耻骨直肠肌附着点到耻骨联合下缘到末端尾椎1-2间隙的连线的垂线(M线)长度、肛提肌角度(LPA)及髂骨尾骨肌角度(ICA)均明显大于对照组(P<0.05)。观察组的髂骨尾骨肌厚度(ICT)明显小于对照组(P<0.05)。结论 MRI可显示出产妇产后早期的盆底功能及形态变化,对产后盆底功能障碍的早期评估有重要的作用。

Objective To explore the application of magnetic resonance imaging(MRI)in the early evaluation of postpartum pelvic floor dysfunction.Methods A total of 80 cases of patients with postpartum pelvic floor dysfunction who were admitted to the hospital from March 2016 to March 2018 were selected as observation group.Another 80 cases of women with normal postpartum pelvic floor function at the same period were selected as control group.The two groups were given MRI scan.The results of transverse,sagittal and coronal images at static state and dynamic state were compared between the two groups.Results Under the static and dynamic MRI scans,the areas of illiococcygeous,pubococcygeous and puborectalis in observation group were smaller than those in control group(P<0.05).In observation group,the width of transverse levator ani fissure,LH line(the link of sagittal pubic symphysis to posterior border of anorectal junction),M line(the perpendicular distance between right rectal posterior puborectal muscle attachment point to the link of lower edge of pubic symphysis and the 1-2 gap of terminal caudal vertebra),levator plate angle(LPA)and iliococcygeal angle(ICA)were significantly greater than those in control group(P<0.05).The iliac coccygeal muscle thickness(ICT)in observation group was significantly lower than that in control group(P<0.05).Conclusion MRI can show the pelvic floor function and morphological changes in early postpartum period,and it plays an important role in the early evaluation of postpartum pelvic floor dysfunction.