正常女性静息及最大用力下盆底结构改变的MRI表现  

Changes of the structure of normal female pelvic floors based on magnetic resonance imaging at rest and during maximal pelvic strain

作　　者：韩远远[1] 李勇[1] 钟镜联[1] 潘恒[1] 王东烨[1] 史洁[1] 

机构地区：[1]中山大学孙逸仙纪念医院放射科,广东省广州市510120

出　　处：《中国组织工程研究》2013年第4期647-652,共6页Chinese Journal of Tissue Engineering Research

基　　金：广东省人口计生委科研项目(2007005)~~

摘　　要：背景:MRI 因其具有无放射性、良好的软组织对比及多层面多轴向扫描成像等特点,可对盆底的整体结构进行精确的评估。目的:利用 MRI 观察无症状女性静息状态及最大盆腔用力时盆底解剖结构的变化,为进一步评价盆底功能障碍性疾病建立正常标准。方法:对 23 例无盆底功能障碍及其他盆腔疾患的女性行动态、静态盆腔 MRI 检查,常规观察盆腔器官及盆底结构,在正中矢状位上分别测量不同状态下膀胱颈、子宫颈、肛直肠连接与耻尾线的距离及 HMO分度系统中分别测量肛直肠连接到耻尾线的距离(M 线)、肛直肠连接与耻骨联合下缘连线(H 线);经肛管中部的冠状位上测量肛提肌板的角度的变化,在经耻骨联合下缘的横断位图像上测量盆隔裂孔的面积的变化。结果与结论:盆腔用力时膀胱颈、子宫颈及肛直肠连接较静息状态下均有不同程度的下降;盆腔用力时肛提肌板的角度及盆膈裂孔面积轻度增大;盆腔用力时 H 线及 M 线均有轻度的增大;与静息状态比较,动态时膀胱颈、子宫颈、肛直肠连接的下降、肛提肌板角度的增大及盆膈裂孔面积的增大、H 线及 M 线的增大差异均有显著性意义(P < 0.05)。提示无症状女性静息时及盆腔用力时盆腔器官的位置会有所改变,在耻尾线系统测量和 HMO 系统上测量,盆腔器官的下降程度均未超过正常范围。盆腔用力时肛提肌板的角度及盆膈裂孔面积均可见轻度的增大。BACKGROUND： Magnetic resonance imaging can accurately evaluate the entire structure of pelvic floor due to its advantages of non-radioactivity, good soft tissue contrast and multi-level and multi-axial scan imaging.OBJECTIVE： To study the changes of structure of normal female pelvic floors based on magnetic resonance imaging at rest and during maximal pelvic strain in order to establish normal criteria for the evaluation of pelvic floor dysfunction.METHODS： Twenty-three asymptomatic female and female patients with other pelvic disorders were examined with pelvic dynamic magnetic resonance imaging at rest and during maximal pelvic strain. The distance of bladder neck, cervixand the anorectal to pubococcygeai line in different conditions in mid-sagittal plane, and the length of H-line （from anorectal to the lower edge of pubic symphysis） and M-line （from anorectal to pubococcygeal line） of the HMO system were measured, the change of the levator angle in coronal plane through the middle of the anal canal, and the change of the area of diaphragmatic hiatus in the axial view through the lower edge of pubic symphysis were measured. RESULTS AND CONCLUSION： Compared with rest condition, the connections of bladder neck, cervix and the anorectal were decreased during maximal pelvic strain; the levator angle and the area of diaphragmatic hiatus were increased during maximal pelvic strain; the length of H-line and M-line was slightly increased during maximal pelvic strain, and there was significant difference （P 〈 0.05）. The position of the pelvic organs of normal female at rest and during maximal pelvic strain changed, in the pubococcygeal line system and HMO system measurement,the decreasing degree of pelvic organs was not more than the normal range degree. In pelvic dynamic magnetic resonance imaging, the levator angle and the area of diaphragmatic hiatus were slightly increased.

关 键 词：骨关节植入物 骨与关节图像与影像 MRI 盆底 耻尾线 盆腔用力 解剖 其他基金 

分 类 号：R318[医药卫生—生物医学工程]