经会阴实时三维超声与MRI评估女性子宫形态改变及盆底功能障碍性疾病中的临床意义

Clinical Significance of Real-Time Three Dimensional Ultrasound and MRI in Evaluating Uterine Morphological Changes and Pelvic Floor Dysfunction in Women

目的分析经会阴实时三维超声与MRI评估女性子宫形态改变及盆底功能障碍性疾病(PFD)中的临床意义。方法选取本院2018年4月至2020年2月收治且经妇科检查或手术确诊的120例PFD患者作为研究对象。另选取同期体检的120例健康女性作为对照组。比较两组患者会阴超声及MRI检查结果差异及不同检查诊断PFD的准确率。结果MRI检查示,与对照组比较,PFD组膀胱颈、子宫颈及肛管直肠连接下降距离均较高(P<0.05)。会阴实时三维超声检查示,与对照组比较,PDF组患者膀胱移动度及Valsalva盆膈裂孔面积均较大,子宫后位发生率明显较高,前位发生率明显较低(P<0.05)。120例PFD患者经MRI检查检出115例,与手术诊断一致者111例,诊断准确率为92.50%,漏诊和误诊率分别为4.17%、3.33%;经会阴实时三维超声检出109例,与手术结果一致者101例,诊断准确率为84.17%,两种检查诊断PFD的准确率比较有明显差异(P<0.05)。结论MRI与会阴实时三维超声均可为临床医师提供可靠的PFD患者盆底解剖及功能信息,临床可结合患者实际情况选取检查方法。

Objective To analyze the clinical significance of real-time three-dimensional ultrasound and MRI in evaluating uterine morphological changes and pelvic floor dysfunction(PFD)in women.Methods A total of 120 PFD patients admitted to our hospital from April 2018 to February 2020 and confirmed by gynecological examination or surgery were selected as the research subjects.Another 120 healthy women were selected as the control group.The differences in perineal ultrasound and MRI examination results and the accuracy of different examinations in the diagnosis of PFD were compared between the two groups of patients.Results The MRI examination showed that compared with the control group,the decrease in the bladder neck,cervix and anorectal connection was higher in the PFD group(P<0.05).Real-time three-dimensional ultrasonography of the perineum showed that compared with the control group,the bladder mobility and Valsalva pelvic diaphragm hole were larger in the PDF group,and the incidence of posterior uterus was significantly higher and the incidence of anterior position was significantly lower(P<0.05).115 cases of 120 PFD patients were detected by MRI,and 111 cases were consistent with the surgical diagnosis.The diagnostic accuracy rate was 92.50%,the missed and misdiagnosed rates were 4.17%and 3.33%,and 109 cases were detected by real-time 3D ultrasound through the perineum.There were 101 patients with consistent surgical results,and the diagnostic accuracy was 84.17%.There was a significant difference in the accuracy of the two tests in diagnosing PFD(P<0.05).Conclusion Both MRI and perineal real-time three-dimensional ultrasound can provide clinicians with reliable anatomy and functional information of the pelvic floor of patients with PFD.The clinical method can be selected in accordance with the actual situation of the patient.