MRI对盆底康复治疗前后压力性尿失禁患者肛门提肌的形态学评价  

The role of MRI in morphologic evaluation of the levator ani muscle in patients with stress urinary incontinence before and after rehabilitation therapy

作　　者：徐海东[1] 张玉琴[1] 董海波[1] 

机构地区：[1]宁波市医疗中心李惠利医院放射科,浙江315040

出　　处：《放射学实践》2016年第1期76-80,共5页Radiologic Practice

摘　　要：目的：探讨MRI在肛门提肌形态学和功能学评估中的应用价值，以期为压力性尿失禁（SUI）患者骨盆康复治疗的疗效评价提供依据。方法：25例SUI患者骨盆康复治疗前后均进行了泌尿妇科尿动力学检测和MRI检查，记录肌肉缺损程度，评估康复治疗疗效。结果：康复治疗前MRI显示82％的患者肛门提肌不对称，其余患者两侧肛门提肌萎缩。在单侧肛门提肌缺损病例中，肌肉总体积为15～22cm^3，其中肌肉缺损侧的总体积[（9．06±0．31）cm^3]为正常侧[（14．54±4．32）cm^3]的62．3％。在双侧肛门提肌缺损病例中，肌肉两侧较为对称，缺损部位形成纤维脂质斑块。康复治疗后MRI检查结果表明64％的患者治疗完全有效，20％的患者治疗部分有效，16％的患者治疗完全无效。结论：MRI是SUI患者诊断和评估康复治疗疗效的重要检查方法。Objective：To explore the value of magnetic resonance imaging （MRI） in evaluating the morphology and function of levator ani muscle and therefore to provide basis for the clinical treatment in patients with stress urinary inconti- nence （SUI）. Methods：25 SUI patients underwent urodynamic examinations followed by MR examinations and their symp- toms were recorded before and after rehabilitation therapy. All data were analyzed using a prospective study. Results： MR examination results showed asymmetry of the levator ani muscle in 82 % of patients before perineal rehabilitation,while the remaining showed bilateral volume reduction of levator ani muscle. In the cases with unilateral defective levator ani muscle, the total volume of defective muscle was 15~22cm^3. Statistic results demonstrated that the muscle volume in defective side （9.06±0.31cm^3） accounted for 62.3 % of that in the normal side （14.54±4.32cm^3）. In patients with bilateral impair- ment, the muscle was replaced by fibrofatty tissue, without a significant asymmetry between two sides. After perineal reha- bilitation,a ＂complete response＂ was found in 64% of patients, partial response in 20% and no response in 16%. Conclusion：MRI is a useful tool in the diagnosis and evaluation of the effects rehabilitation therapy in SUI patients.

关 键 词：压力性尿失禁 磁共振成像 盆底康复治疗 肛门提肌 

分 类 号：R445.2[医药卫生—影像医学与核医学] R711.59[医药卫生—诊断学]