超声剪切波弹性成像联合常规四维盆底超声诊断盆底功能障碍价值

Diagnostic value of ultrasound shear wave elastography combined with conventional four-dimensional pelvic floor ultrasound for the pelvic floor dysfunction of patients

目的:探讨超声剪切波弹性成像(SWE)联合常规四维盆底超声诊断盆底功能障碍价值。方法:收集2020年12月-2023年12月于本院行盆底超声检查女性患者80例临床资料,均常规四维盆底超声检查与SWE检查,统计盆底功能障碍发生情况,按是否发生盆底功能障碍分为障碍组与正常组,比较两组常规四维盆底超声、SWE指标,采用受试者工作特征(ROC)曲线分析SWE联合常规四维盆底超声诊断盆底功能障碍价值。结果:80例患者中有19例发生盆底功能障碍,发生率23.8%。障碍组最大乏氏动作(Valsalva)状态下子宫颈外口移动度(COD)(9.85±2.05 mm)、膀胱颈活动度(BND)(22.68±4.01 mm)均大于正常组(5.91±1.62 mm、19.75±3.99 mm),静息状态下右侧耻骨直肠肌(PR)杨氏模量值(35.74±5.32 kPa)大于正常组(19.91±3.07 kPa),最大Valsalva状态下右侧PR杨氏模量值(36.10±4.36 kPa)低于正常组(39.92±4.51 kPa)(均P<0.05)。COD、BND、静息状态下右侧PR杨氏模量值、最大Valsalva状态下右侧PR杨氏模量值联合检测诊断盆底功能障碍的曲线下面积为0.986,敏感度94.7%、特异性73.8%,高于各指标单独诊断(P<0.05)。结论:SWE联合常规四维盆底超声诊断女性盆底功能障碍有较高应用价值,为临床早期盆底功能障碍诊断提供参考。

Objective:To study the diagnostic value of ultrasound shear wave elastography(SWE)combined with conventional four-dimensional pelvic floor ultrasound for the pelvic floor dysfunction of patients.Methods:The clinical data of 80 patients who had undergone the pelvic floor ultrasound examination from December 2020 to December 2023were collected.All the patients were given conventional four-dimensional pelvic floor ultrasound examination and SWE examination.The occurrence of the pelvic floor dysfunction of these patients was counted.According to whether the pelvic floor dysfunction occurred or not,these patients were divided into group A(patients with pelvic floor dysfunction)and group B(patients without pelvic floor dysfunction).The values of the conventional four-dimensional pelvic floor ultrasound and SWE indicators of the patients were compared between the two groups.Receiver operating characteristic(ROC)curve was used to analyze the application value of SWE combined with the conventional four-dimensional pelvic floor ultrasound for diagnosing the pelvic floor dysfunction of the patients.Results:There were 19 of 80 patients with pelvic floor dysfunction,with a total incidence of 23.8%.The cervix orifice distance(COD)(9.85±2.05mm)and the bladder neck descent(BND)(22.68±4.01 mm)under the maximum Valsalva state of the patients in group A were significantly greater than those(5.91±1.62 mm and 19.75±3.99 mm)of the patients in group B(P<0.05).The Young's modulus value of right puborectalis(PR)of the patients(35.74±5.32 kPa)under the resting state of the patients in group A was significantly higher than that(19.91±3.07 kPa)of the patients in group B,and the Young's modulus value of right PR(36.10±4.36 kPa)of the patients in group A under the maximum Valsalva state was significantly lower than that(39.92±4.51 kPa)of the patients in group B(all P<0.05).The area under the curve,the sensitivity and the specificity of the combined detections of the values COD,BND,the right PR Young's modulus under the resting state and the right PR Young's modulus under the maximum Valsalva state of the patients for diagnosing their pelvic floor dysfunction were 0.986,94.7%and 73.8%,respectively,and which were significantly higher than those of the single detection(P<0.05).Conclusion:SWE combined with conventional four-dimensional pelvic floor ultrasound for diagnosing the pelvic floor dysfunction of the female patients has high application value,which can provide reference for the early clinical diagnosis of pelvic floor dysfunction of the patients.