动态MRI应用耻尾线及耻骨中线诊断盆腔多器官脱垂分度的初步研究  

Preliminary study of dynamic MR imaging for staging female pelvic organ prolapse with the pubococcygeal and midpubic lines

作　　者：武靖[1] 康钰[1] 苗娅莉[2] 王建六[2] 洪楠[1] 

机构地区：[1]北京大学人民医院放射科,100044 [2]北京大学人民医院妇产科

出　　处：《中国妇产科临床杂志》2013年第1期47-49,共3页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：卫生部重点学科项目(2007-353);首都医学发展科研基金项目(2007-301122)

摘　　要：目的评价盆腔动态磁共振(magnetic resonance imaging,MRI),应用耻尾线(pubococcygeal line,PCL)和耻骨中线(midpubic line,MPL)诊断盆腔多器官脱垂疾病程度的价值。方法对21例临床疑诊盆腔器官脱垂患者分别进行POP-Q测量及动态磁共振检查,用盆腔矢状位MRI Fiesta扫描序列获得患者静息和最大用力屏气期间盆腔矢状面影像,分别测量PCL线和MPL线,评价有无阴道前壁脱垂,子宫脱垂和阴道后壁脱垂及脱垂程度,与POP-Q测量的结果进行kappa一致性检验。结果 MRI经PCL线诊断阴道前壁脱垂、子宫脱垂、阴道后壁脱垂分度与POP-Q的一致性分别为k=0.018、k=0.257、k=0.118;MRI经MPL线诊断阴道前壁脱垂、子宫脱垂、阴道后壁脱垂分度与k=0.169、k=0.250、k=0.118。结论盆腔动态MRI行PCL线和MPL线均能全面评价盆腔多器官脱垂情况,但两者与临床POP-Q检查对盆腔器官脱垂分度的一致性不高。Objective To assess the clinical value of dynamic MRI for staging female pelvic organ prolapse （POP） with the pubococcygeal line （PCL） and the midpubic line（MPL）.Methods Twenty-one patients with POP underwent dynamic mid-sagittal plane pelvic MRI using Fiesta sequence during rest and Valsalva maneuver. Two radiologists assessed the stages on MRI for each pelvic compartment （anterior, apical, posterior） by consensus using PCL and MPL reference lines. Agreement between MRI and clinical diagnosis was estimated using weighted kappa. Results Agreement between clinical and PCL staging was fair in the apical（k=0.257） and poor in the anterior （k=0.018）and posterior （k=0.118）; Agreement between clinical and MPL staging was fair in the apical（k=0.250） and poor in the anterior （k=0.169）and posterior（k=0.118）.Conclusions Dynamic MRI examination may evaluate the pelvic organ prolapsed comprehensively what ever use PCL line or MRL line. However, neither reference line has good agreement with clinical staging.

关 键 词：盆腔功能障碍 磁共振成像 耻尾线(PCL) 耻骨中线(MPL) 

分 类 号：R445.2[医药卫生—影像医学与核医学]