动态磁共振成像对已婚未育女性盆底功能评估的应用探讨

Application of dynamic magnetic resonance imaging in the assessment of pelvic floor function in married and childless women

目的探讨已婚未育女性孕前盆底功能和形态的磁共振成像变化特征。方法对31名已婚未育女性志愿者行盆底的静息及动态磁共振成像检查,分别测量盆腔脏器(膀胱底部、宫颈下端和肛管直肠交界处)在静息位与最大腹压(即最大力排期)时至耻尾线(PCL线)及耻骨中线(MPL线)的距离及动静态的最大腹压时变化幅度。结果膀胱底部、宫颈下端和肛管直肠交界处在静息位与最大腹压时至PCL线距离分别为:静息位(2.23±0.51)、(2.11±0.72)与(0.93±0.40)cm,最大腹压(0.97±1.07)、(0.72±1.06)与(1.60±0.79)cm,差异有统计学意义(P<0.05);膀胱底部、宫颈下端、肛管直肠连接处到MPL线距离分别为:静息位(2.82±0.57)、(2.11±0.72)与(0.93±0.40)cm,最大腹压(2.68±0.41)、(4.52±1.32)与(2.91±0.74)cm,差异无统计学意义(P>0.05);最大腹压膀胱底部、宫颈下端和肛管直肠交界处至PCL线距离变化幅度分别为:(1.26±0.95)、(1.39±1.08)与(0.66±0.63)cm,至MPL线距离变化幅度分别为:(0.14±0.60)、(0.60±1.05)与(0.18±0.66)cm,最大腹压盆腔脏器至PCL及MPL线距离幅度差异有统计学意义(P<0.05)。结论动态MRI检查可以直观地观察女性孕前盆底的形态和运动功能变化,最大腹压时以PCL为基线较MPL线观察盆腔脏器下降程度更敏感。

Objective To investigate the magnetic resonance imaging changes of pelvic floor function and morphology in married and childless women before pregnancy.Methods Resting and dynamic magnetic resonance imaging of pelvic floor were performed on 31 married and childless female volunteers,and pelvic organs(the bottom of the bladder,the lower end of the cervix,and the junction of the anorectum)were measured respectively at resting position and maximum abdominal pressure(ie,maximum scheduling)to the pubococcygeal line(PCL line)and mid-pubic line(MPL line)and the magnitude of the maximum abdominal pressure change.Results The distances from the pelvic organs(the bottom of the bladder,the lower end of the cervix and the junction of the anorectum)to the PCL line at resting and maximum abdominal pressure were:resting position(2.23±0.51),(2.11±0.72)and(0.93±0.40)cm,maximum abdominal pressure(0.97±1.07),(0.72±1.06)and(1.60±0.79)cm,and the difference was statistically significant(P<0.05);the distances from pelvic organs(bladder floor,lower cervix,anorectal junction)to the line of MPL were:resting(2.82±0.57),(2.11±0.72)and(0.93±0.40)cm,maximum abdominal pressure(2.68±0.41),(4.52±1.32)and(2.91±0.74)cm,and no difference was statistically significant(P>0.05);the distance amplitudes of pelvic organs(bladder floor,lower cervix,and anorectal junction)to the PCL line at the time of maximum abdominal pressure were:(1.26±0.95),(1.39±1.08)and(0.66±0.63)cm,and the distance to MPL line were(0.14±0.60),(0.60±1.05)and(0.18±0.66)cm,and the difference in the distance from maximal abdominal pressure pelvic organ to PCL and MPL line was statistically significant(P<0.05).Conclusion Dynamic MRI can visually observe the morphological and motor function changes of the pelvic floor at the time of maximum abdominal pressure.The line of PCL to baseline descent is more sensitive than the line of MPL observation of pelvic organs(bladder floor,lower cervix,and anorectal junction)