经会阴实时三维超声评估正常女性盆底结构的重复性研究  

Reproducibility of the transperineal real-time three-dimensional ultrasound for evaluation of normal female pelvic floor structure

作　　者：黄泽萍[1] 毛永江[1] 杨丽新[1] 张新玲[1] 张曼[1] 郑志娟[1] 曹君妍[1] 

机构地区：[1]中山大学附属第三医院超声科,广州510630

出　　处：《中华超声影像学杂志》2014年第11期966-969,共4页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金（81201178）

摘　　要：目的研究实时三维超声评估正常女性盆底结构的重复性和一致性。方法两位不同经验的操作者，分别测量42例正常成年女性Valsalva后的膀胱颈移动度、肛提肌裂孔面积，研究不同操作者组内和组间的重复性。比较各组测值的差异，运用组内相关系数（intraclass correlation coefficient，ICC）、变异系数（variation coefficient，CV）和Bland-Altman分析来评价各组的一致性和重复性。结果经验丰富的操作者1和经验少的操作者2测得正常女性膀胱颈移动度分别为（18．48±5．84）cm和（17．79±5．48）cm，二者比较差异无统计学意义（P=0．222）；Valsalva的最大肛提肌裂孔面积分别为（17．53±3．95）cm^2和（17．31±4．32）cm^2，二者比较差异无统计学意义（P=0．344）。不同操作者之间测量正常女性膀胱颈移动度、Valsalva后的最大肛提肌裂孔面积的ICC分别为0．89和0．90，CV分别为7．26％和3．03％。经验丰富的操作者重复性（ICC=0．99、0．94）优于经验较少者（ICC 0．92、0．81）。Bland-Altman图像分析结果显示两个不同经验操作者之间一致性较好。结论运用实时三维超声技术检测女性盆底结构在不同操作者间总体重复性和一致性较好。同一操作者的检测效能优于不同操作者；经验丰富的操作者检测效能优于经验较少者，加强对低年资医师培训可更进一步提高测量准确性。Objective To study the repeatability and consistency of normal female pelvic floor structure using transperineal real-time three-dimensional ultrasound.Methods Forty-two cases of normal adult female were evaluated by two different experience operator, using the real-time three-dimensional ultrasound diagnostic apparatus. The bladder neck movement degrees and the levator hiatus area were observed after Valsalva condition. Differences between the groups were compared. Intraclass correlation coefficient （ICC）, the coefficient of variation （CV） and Bland-Ahman analysis of consistency were evaluated. Results The bladder neck movement degrees and the levator hiatus area measured by the experienced operator （operator 1） and less experienced operator（operator 2） were （18.48 ± 5.84）cm and （17.79 ± 5.48） cm, （17.53± 3.95）cm^2 and （17.31 ± 4.32）cm^2 , respectively.There was no significant difference between the two operators （P 〉 0.05）. The intra-ICC were 0.89 and 0.90, CV were 7.26M and 3.03%. Experienced operator repeatability （ICC = 0.99,0.94） was slightly higher than the less experienced researchers （ICC 0.92,0.81）.The analysis results of Bland-Ahman image showed good consistency between two different operators.Conclusions The current study proves real-time three-dimensional ultrasound is a reproducible method for female pelvic floor structure assessment, and the reproducibility is very well. The detection performance of experienced operator slightly better than the one with less experience, strengthen the training of junior doctors may further improve the accuracy of measurement.

关 键 词：超声检查 三维 骨盆底 结果可重复性 

分 类 号：R445.1[医药卫生—影像医学与核医学]