盆底功能性疾病的动态MRI研究

Dynamic MRI Study of Functional Disorders of Pelvic Floor

目的 评价盆底动态MRI形态学表现与盆底功能性疾病的相关性。资料与方法 采用Siemens 1.0T超导磁共振成像仪对 6 0例妇女进行MRI检查 ,将这些受试者分为两组 :30例为无症状健康志愿者和 30例为盆底功能性疾病患者。采用仰卧位使用梯度回波二维FLASHT1WI快速扫描序列获得屏气期间盆底横断面、冠状面和矢状面的静息和最大盆腔用力时MR影像。所有影像用于观测盆腔器官脱垂和盆底形态 ,比较两组间盆腔器官脱垂和盆底形态变化的程度。结果 盆腔器官脱垂常发生于多个部位 ,盆底功能性疾病患者发生频率较高 ,与健康受试者比较相差显著 :膀胱膨出 (P <0 .0 1) ,子宫颈脱垂 (P <0 .0 1) ,盆底疝 (P <0 .0 1) ,直肠连接异常下降 (P <0 .0 1) ,直肠膨出 (P <0 .0 1)和盆隔裂孔膨胀 (P <0 .0 1)。结论 盆底动态MRI可用于准确评价盆腔器官脱垂和盆底形态 ,盆底功能性疾病患者常出现整个盆底软弱 。

Objective To study dynamic MRI manifestations of the pelvic floor, to discuss the correlation between MRI findings and the functional disorders of the pelvic floor. Materials and Methods With a 1.0T Seimens MR scanner, MRI was performed in 30 healthy volunteer women (control group) and in 30 women with pelvic floor functional diseases (study group). Using fast gradient echo sequence 2D FLASH T 1WI, axial, coronal and sagittal imaging was carried out during both rest and pelvic strain phase. The observation was focused on the pelvic visceral prolapse and pelvic floor pattern. The results were compared between two groups.Results Pelvic visceral prolapse usually occurred at multiple sites. The occurrence of abnormalities, including cystocele, uterocervical prolapse, pelvic floor hernia, abnormal descent of anorectal junction, rectocele and expansion of pelvic diaphragm hiatus, in study group was significantly higher than that in control group (P<0.01).Conclusion Dynamic MRI of pelvic floor can accurately display pelvic visceral prolapse and pelvic floor pattern. Total weakness of the pelvic floor is often seen in the patients with pelvic floor functional disorders. Pelvic visceral prolapse occurs in multiple sites with marked expansion of pelvic diaphragm hiatus.