磁共振成像对盆腔器官脱垂女性患者的诊断价值

Diagnostic Value of Magnetic Resonance Imaging in Female Patients with Pelvic Organ Prolapse

目的探讨磁共振成像(MRI)检查对盆腔器官脱垂(POP)患者的诊断价值。方法选取2020年8月至2022年1月在罗山县人民医院就诊的81例POP患者,所有患者均于入院时进行临床检查、MRI检查,其中临床检查结果采用盆腔器官脱垂定量(POP-Q)法进行分期,MRI检查采用休克尔分子轨道(HMO)法进行分期,以临床检查结果为“金标准”,统计MRI检查诊断结果、诊断效能,分析MRI检查、临床检查对前、中、后盆腔器官脱垂程度诊断的一致性,另选取56例同期就诊的POP合并压力性尿失禁(SUI)患者,比较两组MRI检查测量参数。结果经临床检查及POP-Q分期诊断:81例POP患者中阴道前壁膨出58例;子宫脱垂55例,阴道穹窿脱垂4例;阴道后壁膨出43例。经MRI检查及HMO分度诊断:膀胱膨出66例;阴道穹窿脱垂4例,子宫脱垂50例;肠疝23例,直肠膨出38例。MRI检查对于前、中、后盆腔诊断准确率分别为85.19%、91.36%、72.84%;MRI检查与临床检查对于前、中、后盆腔脱垂的诊断一致性Kappa值分别为0.593、0.796、0.439;与POP患者相比,POP合并SUI患者MRI检查参数M线、盆膈裂孔横径较短,膀胱尿道后角(RVA)、尿道倾斜角(UIA)较大(P<0.05)。结论MRI检查可进一步提高POP诊断准确率,可用于辅助鉴别患者是否合并SUI,对临床早期诊断、及时制定干预措施具有重要意义。

Objective To investigate the diagnostic value of magnetic resonance imaging(MRI)in patients with pelvic organ prolapse(POP).Methods A total of 81 patients with POP who were treated in Luoshan County People’s Hospital from August 2020 to January 2022 were selected,all patients underwent clinical examination and MRI examination.The clinical examination results were staging by quantitative of pelvic organ prolapse(POP-Q)method,and the MRI examination was staging by Huckel molecular orbital(HMO)method.Taking clinical examination as the“gold standard”,the diagnostic results and diagnostic efficiency of MRI examination were calculated,and the consistency of MRI examination and clinical examination in the diagnosis of pelvic organ prolapse was analyzed,another 56 patients with POP complicated with stress urinary incontinence(SUI)who visited the clinic during the same period were selected,and the measurement parameters of MRI examination were compared between the two groups.Results According to the clinical examination and POP-Q staging diagnosis,among the 81 POP patients,58 had anterior vaginal prolapse,55 had uterine prolapse,4 had vaginal vault prolapse and 43 had prolapse of the posterior vaginal wall.Diagnosed by MRI and HMO classification:66 cases of cystocele,4 cases of vaginal vault prolapse,50 cases of uterine prolapse,23 cases of intestinal hernia and 38 cases of rectocele.The diagnostic accuracy rates of MRI examination for anterior,middle and posterior pelvic prolapse were 85.19%,91.36%and 72.84%,respectively.The Kappa values of MRI examination and clinical examination for the diagnosis of anterior,middle and posterior pelvic prolapse were 0.593,0.796,0.439.Compared with patients with POP,patients with POP and SUI had shorter MRI parameters such as M-line and transverse diameter of pelvic diaphragmatic hiatus,and larger retro vesicourethral angle(RVA)and urethral inclined angle(UIA)(P<0.05).Conclusion MRI examination can further improve the diagnostic accuracy of POP,and can be used to assist in the identification of patients with SUI,which is of great significance for early clinical diagnosis and timely development of intervention measures.