女性压力性尿失禁尿道中段韧带改变的MRI评价  

MRI assessment of mid-urethral ligament changes in female stress urinary incontinence

作　　者：白玫[1] 刘弘毅[2] 韩悦[1] 徐国萍[1] 方平[1] 赵阳[1] 李京津[1] 

机构地区：[1]天津医科大学第二医院放射科,300211 [2]天津医科大学检验学院生化教研室

出　　处：《中华放射学杂志》2012年第4期336-339,共4页Chinese Journal of Radiology

摘　　要：目的探讨MR／诊断女性压力性尿失禁（SUI）患者尿道中段韧带损伤性改变的价值。方法回顾性分析20例经手术治疗的女性SUI患者及30名健康女性志愿者盆腔MRI表现并对比分析，观察女性SUI患者尿道中段韧带损伤的MRI表现特征。SUI患者尿道中段韧带形态改变的比较采用χ2检验。结果女性尿道中段的支持韧带包括尿道周围韧带（1条）、耻骨尿道韧带（2条）、尿道旁韧带（2条）和尿道下韧带（1条），韧带在正常时于T1WI和T2WI上均呈细条状偏低信号，具有张力感；30名志愿者中有6名（20％）可见尿道周围韧带走行迂曲，呈松弛状。20例SUI患者尿道中段韧带的损伤性改变表现为韧带的松弛或断裂，松弛和断裂的发生率分别为39％（47／120）和42％（50／120），差异有统计学意义（χ2=43．191，P〈0．05）；韧带松弛表现为韧带失去张力感呈漂浮状，还可表现为一侧韧带较对侧延长、变细，韧带断裂表现为韧带信号的连续性中断、韧带挛缩且一端与附着点分离。结论MRI可客观、有效地评价女性SUI患者尿道中段韧带的病理性改变。Objective To evaluate the MRI value in changes of mid-urethral ligament injury of female stress urinary incontinence （SUI）. Methods Comparison of MRI changes of mid-urethral ligament on 30 healthy female volunteers and 20 female SUI patients. Chi-square test was used to compare the form of SUI patient＇s mid-urethral support ligaments Results The female mid-urethral support ligaments were composed of 4 groups of ligaments, including the periurethral ligament and pubourethral ligaments （1 pair） , and at both sides of the urethra＇s paraurethral ligaments （1 pair） and suburethral ligament lying dorsal urethra, connecting the urethra and pelvic arcus tendinous fasciae. In normal MRI, ligament was a thin strip and showed low signal on both T1WI and T2WI, T2WI sagittal and cross-section scan was the best combination to show the middle urethral support ligaments changes, with tension; 6 patients （20%） in the 30 patients normal control group could be seen tortuously and slack like around the urethra ligaments. Twenty SUI patients mid-urethral support ligaments were performance laxity or rupture, rates were 39% （47/120） and 42% （50/120） （χ2 = 43. 191 ,P 〈 0. 05）. On T2WI, the ligamentous laxity was floating, and loss tension, also could performance one side extension and thinner than the other side. The ligament rupture was performance of the signal interruption, ligament contraeture aml one end of ligament attachment points separation. Conclusion MRI can objective effective evaluate the mid-urethral support ligaments＇ pathological changes in stress urinary incontinence patients.

关 键 词：韧带 尿失禁 压力性 磁共振成像 

分 类 号：R699[医药卫生—泌尿科学]