摘要
目的探讨女性压力性尿失禁（SUI）患者MRI盆隔裂孔各径线动态变化特征。方法回顾性分析临床诊断为SUI的30例女性患者作为SUI组，招募无症状成年女性志愿者30名作为对照组。所有受检者均分别在静息态及Valsava状态下（屏气最大用力排尿动作）行盆腔MRI平扫。在横轴面图像上测量盆隔裂孔面积（LHA）、前后长径（LHL）及最大左右宽径（LHW）；在正中矢状面像上测量位盆隔裂孔前后径（H线距）。对2组受检者盆隔裂孔各指标测量值的比较采用独立样本t检验，对静息态及Valsaval状态下盆隔裂孔各指标测量值的比较采用配对t检验。结果静息状态下，SUI组的LHA、LHL、LHW和H线距分别为（28．7±19.3）cm^2、（7．1±2．2）cm、（4．7±1．6）cm和（5．7±1．1）cm，对照组上述测量值分别为（13．1±3．7）cm^2、（5．3±0．8）cm、（3．4±0．5）cm和（5．7±0．9）cm，2组间LHA、LHL、LHW差异有统计学意义（t值分别为4．33、4．36、4．23，P值均〈0．01），H线距差异无统计学意义（P〉0．05）。Valsaval状态下，SUI组的LHA、LHL、LHW和H线距分别为（40．0±26．0）cm^2、（8．0±2．3）cm、（6．0±2．5）cm和（6．1±1．5）cm，对照组上述测量值分别为（16．2±6．2）cm^2、（5．5±1．0）cm、（3．6±0．8）cm和（6．0±1．0）cm，2组间LHA、LHL、LHW差异有统计学意义（f值分别为4．88、5．36、4．91，P值均〈0．01），H线距差异无统计学意义（P〉0．05）。SUI患者静息态和Valsaval状态间LHA、LHL、LHW差异有统计学意义（P值均〈0．01），对照组静息态和Valsaval状态间LHA、LHL差异均有统计学意义（P值均〈0．05）。结论动静态盆腔MRI可以较直观、准确地评价盆隔裂孔的形态及变化，女性SUI患者盆隔裂孔各径线扩大。
Objective To investigate the dynamic changes in each radical line of pelvic floor levator hiatus in female with stress urinary incontinence（SUI）. Methods A retrospective analysis of MR images was performed in 30 female patients with clinically diagnosed SUI and 30 asymptomatic female volunteers recruited as reference group. All of the subjects underwent pelvic MRI scanning both in static statusand Valsalva maneuver, respectively, Valsalva was performed by attempt to forcibly urinate while holding her breath, respectively. Area of pelvic diaphragm hiatus （LHA）, ntero-posterior length （LHL） and tmixmum width （LHW） were measured in horizontal axis plane of the obtained images.H line distance was measured in the midsagittal plane. Independent sample t test was performed to compare the difference in LHA, LHL and LHW between two groups. Paired t test was used to compare difference in LHA, LHL and LHW between two groups in static status and Valsalva maneuver, respectively. Results In static status, the values in LHA, LHL, LHW and H line distance for SUI groups were（28.7±19.3） cm2, （7.1±2.2）cm, （4.7±1.6 ） cm and （5.7±1.1） cm, respectively. The parameters for the reference group were（13.1±3.7） cm2, （5.3±0.8） cm, （3.4±0.5） cm and （5.7±0.9） cm, respectively. The difference in LHA, LHL, LHW between two groups was statistically significant （t=4.33, 4.36, 4.23, and P〈0.01 for all indexes）, whereas the difference in H line distance between two groups was no statistically significanct because of P〉 0.05. In Valsalva maneuver, LHA, LHL, LHW and H line distance were （40.0±26.0） cm2, （8.0±2.3） cm, （6.0±2.5） cm and （6.1±1.5）era for SUI group, and were （16.2±6.2） cm2,（5.5±1.0） cm, （3.6±0.8） cm and （6.0±1.0） cm for the reference group, respectively. The difference in LHA, LHL and LHW between two groups was statistically significant, （t=4.88, 5.36, 4.91 respectively, and P〈 0.01）, whereas the differeneein H value between two groups was no statistically significant （P〈 0.05）. For SUI group , the difference of LHA, LHL and LHW between static status and Valsalva maneuver had statistically significant with P〈0.01. For reference group, the difference of LHA and LHL between static status and Valsalva maneuver had statistically significant（P〈0.05）. Conclusion Dynamic and static pelvic MRI can evaluate the morphology and variation of pelvic floor levator hiatus much intuitively and accurately, pelvic floor levator hiatus becomes enlarged in female with SUI.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2015年第9期661-664,共4页
Chinese Journal of Radiology
关键词
尿失禁
压力性
磁共振成像
盆隔裂孔
Urinary incontinence, stress
Magnetic resonance imaging
Levator hiatus
