不同年龄女性正常盆底结构的MRI初步研究  

Anatomical Study of Normal Female Pelvic Floors Using Magnetic Resonance Imaging

作　　者：韩远远[1] 李勇[1] 史洁[1] 梁碧玲[1] 黄穗乔[1] 钟镜联[1] 

机构地区：[1]中山大学孙逸仙纪念医院放射科,广东广州510120

出　　处：《中山大学学报（医学科学版）》2012年第4期520-523,共4页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省人口计生委科研项目(2007005)

摘　　要：【目的】探讨不同年龄女性正常盆底MRI静息状态下的解剖和功能状态,为动态MRI评价盆底功能障碍性疾病建立盆腔器官运动程度和盆底形态学的正常标准。【方法】按照年龄分别选择20～40岁、40～60岁及60岁以上共三组无盆腔疾病、无盆底功能障碍的临床症状的女性,每组20人共60例,均行静息状态下的盆腔MRI检查,常规观察盆腔器官及盆底结构,并在正中矢状位上分别测量膀胱颈、子宫颈、肛直肠连接与耻尾线即耻骨联合下缘至第一、二尾椎间隙的连线(pubococcygeal line,PCL)的距离,在经肛管中部的冠状位上测量肛提肌板的角度,在经耻骨联合下缘的横断位图像上测量盆膈裂孔的面积。【结果】静息状态下膀胱颈与子宫颈均位于PCL以上,膀胱颈距离PCL的均数值三个年龄组之间差异有统计学意义(P<0.05);子宫颈距离PCL的均数值三个年龄组之间差异无统计学意义(P>0.05);肛直肠连接在PCL附近,各年龄组之间差异无统计学意义。盆膈裂孔的面积及肛提肌板的角度随着组之间年龄的增大而加大,之间差异有统计学意义(P<0.05)。右侧耻骨直肠肌薄于左侧。【结论】正常女性膀胱颈随着年龄增长逐渐下移,与子宫颈均位于PCL以上,肛直肠连接不超过PCL以下1.5 cm;随年龄增长盆隔裂孔逐渐增大,肛提肌逐渐下降。双侧耻骨直肠肌可不对称。MRI可全面显示女性盆底结构及功能状态。[Objective] To study the anatomy and function of normal female floor using static magnetic resonance imaging, to establish normal criteria of position and morphology of pelvic organs and pelvic floor in MRI for the use of proceeding study in pelvic floor dysfunction. [ Methods ] Sixty asymptomatie female without pelvic lesion were included and divided into three groups according to their age ： 20-40 years old, 40-60 years old and exceed 60 years old. All of them have done pelvic static MRI. The distance of bladder neck,nterin cervix and anoreetal junction to pubococcygeal line （PCL） in different age in mid-sagittal plane, the levator angle in coronal plane through the middle of the anal canal, and the width, length and area of levator hiatus in the axial view through the lower edge of pubic symphysis were measured. [ Results ] The bladder neck and uterin cervix did not descend more than the PCL, and the location of anorectal junction were near the PCL. The distance of the bladder neck to PCL were different in each groups, and the difference was statistically significant （P 〈 0.05 ）. The area of levator hiatus and the levator angle gradually increased in different groups,but the difference was no statistically significant （P 〈 0.05）. The right side of the puborectalis is thinner than the left. [Conclusions] The bladder neck and uterin cervix were gradually descending with age. The anoreetal junction should not descend more than the 1.5 cm below PCL. The hibateral puborectal muscles were asymmetric in normal female. MRI can cleally show the female pelvic anatomy and function.

关 键 词：MRI成像技术 盆底 耻尾线 

分 类 号：R812[医药卫生—放射医学]