MRI阴道形态异常对盆底器官脱垂的提示价值  

The prompt value of abnormal vaginal morphology on MRI for diagnosing pelvic organ prolapse

作　　者：赵玉娇[1] 崔璨[1] 谢双双[2] 李娜[1] 黄黎香[2] 程悦[2] 陈丽华[2] 柴超[2] 沈文[2] 

机构地区：[1]天津医科大学一中心临床学院放射科,300192 [2]天津市第一中心医院放射科

出　　处：《中华放射学杂志》2017年第1期38-41,共4页Chinese Journal of Radiology

摘　　要：目的：探讨MRI阴道形态异常对盆底器官脱垂的提示价值。方法前瞻性收集经临床盆腔器官脱垂定量评价标准诊断为盆腔器官脱垂的女性患者48例作为盆腔器官脱垂组，健康女性志愿者51名作为对照组。所有受试者均行盆腔MRI检查。在横断面DelancyⅡ水平观察阴道形态，分为形态正常（H形）或异常（非H形）。观察盆腔器官脱垂程度（分为0、Ⅰ、Ⅱ、Ⅲ、Ⅳ度）和脱垂类型（分为前、中、后盆腔脱垂），记录不同脱垂程度与脱垂类型受试者MRI横断面像上阴道形态分布情况。采用c2检验比较对照组和盆腔器官脱垂组阴道形态的差异，采用ROC曲线评价阴道形态异常诊断盆腔器官脱垂的效能。结果对照组51例中，阴道形态正常40例，阴道形态异常11例，主要表现为W形和U形；盆腔器官脱垂组48例中，阴道形态正常5例，形态异常43例，其中U形13例、W形26例、O形4例。对照组和盆腔器官脱垂组阴道形态的差异有统计学意义（c2=46.137，P〈0.01）。采用阴道形态异常诊断盆腔器官脱垂的ROC下面积为0.800，诊断敏感度和特异度分别为89.6%和78.4%。不同脱垂程度和脱垂类型受试者阴道形态异常的分布不同，其中0度脱垂组阴道形态以H形为主（40/51，78.4%），Ⅰ度脱垂阴道形态以W形为主（16/28，57.1%），Ⅱ、Ⅲ度脱垂阴道形态全部表现为非H形（20/20，100%），其中Ⅱ度脱垂阴道形态以W形为主（9/14），Ⅲ度以O形为主（3/6）。前盆腔脱垂以W形为主（4/9），中盆腔脱垂以O形为主（4/7）。结论阴道形态异常对盆腔器官脱垂有一定提示价值，不同异常阴道形态能提示不同程度和类型的器官脱垂情况。Objective To investigate the prompt value of abnormal vaginal morphology on diagnosing pelvic organ prolapse . Methods Forty eight pelvic organ prolapse female patients diagnosed by pelvic organ prolapse quantification were enrolled in the pelvic organ prolapse group and 51 normal female volunteers were enrolled in the control group in this study. Pelvic MRI T2WI were performed in all cases. The vaginal shape were evaluated according to Delancey Ⅱ level on the transverse images, which were divided into two categories：normal morphology （H-shaped） and abnormal morphology（non H-shaped）. The vaginal shape distribution of different prolapse degree（0,Ⅰ,Ⅱ,Ⅲ,Ⅳstage） and types（anterior,middle, posterior pelvic prolapse） were recorded. Chi-square test was used to analyse distribution difference of vaginal shape between the two groups. The ROC curve was used to analyse the diagnostic efficiency of abnormal vaginal morphology for diagnosing pelvic organ prolapse. Results In the control group, there were 40 cases with normal vaginal morphology and 11 cases with abnormal morphology mainly including W-shaped and U-shaped abnormal morphology. In the prolapse group, there were 5 cases with normal vaginal morphology and 43 cases with abnormal morphologymainly including U-shaped （13 cases）,＆amp;nbsp;W-shaped （26 cases） and O-shaped（4 cases） abnormal morphology. There was significant difference between the two groups（c2=46.137,P〈0.01）. The area under the curve （AUC） was 0.800. The sensitivity and specificity of abnormal vaginal shape for diagnosing pelvic organ prolapse were 89.6% and 78.4%respectively.The distribution of vaginal morphology in different degrees and types of prolapse were different：vaginal morphology of 0 stage prolapse showed H-typed mainly （40/51, 78.4%）, Ⅰ stage prolapse showed W-shaped （16/28 57.1%）, Ⅱ,Ⅲ stage prolapse all showed non H-shaped （20/20, 100%）, Ⅱstage mainly showed W-shaped （9/14）, Ⅲ stage mainly showed O-shaped （3/6）

关 键 词：盆腔脏器脱垂 阴道 磁共振成像 

分 类 号：R711.2[医药卫生—妇产科学]