高分辨率MRI联合动态MRI在盆底功能障碍性疾病中的诊断价值

Diagnostic value of high resolution MRI combined with dynamic MRI in pelvic floor dysfunction disease

目的:探讨高分辨率磁共振成像(MRI)联合动态MRI在盆底功能障碍性疾病(PFD)中的诊断价值。方法:选取2020年1月至2021年1月该院收治的60例高度疑似PFD的患者为研究对象,均行高分辨率MRI与动态MRI检查,以临床综合检查为金标准,统计临床综合检查结果、高分辨率MRI单项及联合动态MRI检查诊断PFD的结果,进行一致性分析,并比较PFD患者、非PFD患者的动态MRI检查图像、盆底肌厚度。结果:经临床综合检查结果显示,60例高度疑似PFD患者确诊44例,占73.33%,其中盆底疝4例,膀胱膨出23例,直肠脱垂12例,直肠膨出5例;经Kappa一致性分析,高分辨率MRI检查诊断PFD的结果与临床综合检查结果的一致性一般(Kappa=0.590,P=0.000);高分辨率MRI联合动态MRI检查诊断PFD的结果与临床综合检查结果的一致性较好(Kappa=0.791,P=0.000);PFD患者膀胱颈下降、子宫颈下降、肛管直肠连接下降水平均高于非PFD患者,差异有统计学意义(P<0.05);PFD患者耻骨直肠肌、髂骨尾骨肌厚度均小于非PFD患者,差异有统计学意义(P<0.05)。结论:高分辨率MRI联合动态MRI检查在PFD中的诊断价值较高。

Objective:To explore diagnostic value of high resolution magnetic resonance imaging(MRI)combined with dynamic MRI in pelvic floor dysfunction disease(PFD).Methods:60 patients with highly suspected PFD admitted to this hospital from January 2020 to January 2021 were selected as the research subjects,and all underwent high resolution MRI and dynamic MRI.Taking the clinical comprehensive examination as the gold standard,the results of clinical comprehensive examination,single high resolution MRI and high resolution MRI combined with dynamic MRI in the diagnosis of PFD were analyzed for consistency.The dynamic MRI images and the pelvic floor muscle thickness were compared among the PFD patients and the non-PFD patients.Results:The results of comprehensive clinical examination showed that 44 of 60 patients with highly suspected PFD were diagnosed,accounting for 73.33%,including 4 cases of pelvic floor hernia,23 cases of cystocele,12 cases of rectal prolapse,and 5 cases of rectocele.The Kappa consistency analysis showed that the results of high-resolution MRI in the diagnosis of PFD were generally consistent with the results of clinical comprehensive examinations(Kappa=0.590,P=0.000);the results of high-resolution MRI combined with dynamic MRI in the diagnosis of PFD were well consistent with the clinical comprehensive examination results(Kappa=0.791,P=0.000).The levels of bladder neck descending,cervix descending,and anorectal junction descending in the PFD patients were higher than those in non-PFD patients,and the differences were statistically significant(P<0.05).Further,the thickness of puborectal muscle and iliococcygeus muscle in the PFD patients were lower than those in the non-PFD patients,and the differences were statistically significant(P<0.05).Conclusions:High resolution MRI combined with dynamic MRI has high value in the diagnosis of PFD.