MRI对女性盆底功能失调肛提肌裂孔解剖及形态的研究  

Anatomical and Morphologic Abnormality of Levator Hiatus in Patients with Pelvic Floor Disorders Using Dynamic MR Imaging

作　　者：黄燕[1] 张国安[2] 张瑞[1] 高元安[1] 王国际[1] 王毅[3] 

机构地区：[1]中国人民解放军第273医院介入/磁共振科,新疆库尔勒841000 [2]中国人民解放军第273医院妇产科,新疆库尔勒841000 [3]重庆第三军医大学大坪医院野战外科研究所放射科,400042

出　　处：《临床放射学杂志》2013年第8期1134-1137,共4页Journal of Clinical Radiology

摘　　要：目的探讨正常女性与盆底功能失调患者力排相MRI肛提肌裂孔形态及解剖结构的变化。方法选择23名女性健康志愿者(对照组)和35例盆底功能失调患者(试验组),采用MRI三维稳态进动快速成像序列采集静息和力排相盆腔横断、冠状和矢状面影像,观测肛提肌裂孔的解剖和形态,比较力排相试验组与对照组肛提肌裂孔面积和解剖结构的变化。结果静息相两组间肛提肌裂孔面积比较差异无统计学意义(P>0.05),力排相试验组肛提肌裂孔面积[(35.9±13.1)cm2]和面积增大百分比[(64.7±22.5)%]均显著大于对照组[(21.7±4.9)cm2和(11.3±6.4)%](P<0.01)。静息相两组受试者肛提肌裂孔解剖结构由前至后均分别为尿道、阴道和肛管,力排相试验组肛提肌裂孔出现膀胱10例(31.3%)、子宫12例(37.5%)、直肠黏膜21例(65.6%)和腹膜脂肪8例(25.0%),而对照组仅发现2例(9.5%)肛提肌裂孔内出现直肠黏膜,经χ2检验差异均有统计学意义(P<0.01或0.05)。结论女性盆底功能失调患者力排相常出现多个盆腔器官向肛提肌裂孔脱垂,并导致肛提肌裂孔异常膨大。Objective To explore the MRI anatomical and morphologic changes of levator hiatus in normal women and female patients with pelvic floor disorders. Methods Twenty-three asymptomatic women volunteers （control group） and 35 patients with pelvic floor disorders （test group） underwent pelvic dynamic MRI examination. Cross sectional, coronal and sagittal MR images were acquired at static phase and straining phase using a fast imaging employing steady state acqui- sition （FEISTA）. The anatomical and morphologic changes of the levator hiatus on the images were observed and compared between test group and control group. Results There was no significant difference of levator hiatus area on static phase MR between two groups （P 〉0.05）. On straining phase MR, the average area of levator hiatus[ （35.9 ± 13.1 ） cm2 ] in test group was obviously bigger than that in control group [ （21.7 ±4.9） cm2 ] （P 〈0.01 ）, and the levator hiatus area in- creased between static phase and straining phase in test group [ （64.7 ± 22.5 ） % ] was obviously bigger than that in control group [ （11.3% ±6.4）% ] （P 〈0.01 ）. On static phase, urethra, vagina and anal canal were showed from anterior to posterior in levator hiatus in both groups. On straining phase, urinary bladder, uterus, rectal mucous membrane and perito- neal fat tissue were found in the levator hiatus in 10 （31.3%）, 12 （37.5%）, 21 （65.6%） and 8 （25.0%） in test group, however, only 2 cases showed rectal mucous membrane in the levator hiatus in control group, which had statistically significant difference between two groups （P 〈 0.01 or 0.05 ）. Conclusion Patient with pelvic floor disorders often devel- op multiple pelvic organs prolapse in the levator hiatus and result in an abnormal dilatation of the levator hiatus on dynamic MR.

关 键 词：盆底 肛提肌裂孔 盆底功能失调 磁共振成像 评价研究 

分 类 号：R445.2[医药卫生—影像医学与核医学]