实时剪切波弹性成像联合灰阶超声评估产妇会阴体肌力变化  

Real-time Shear Wave Elastography Combined with Gray-scale Ultrasound in Evaluating Perineal Body Muscle Tension

作　　者：胡美娟[1] 周爱云[1] 刘娟[1] 徐盼[1] 齐祥飞 HU Meijuan;ZHOU Aiyun;LIU Juan;XU Pan;QI Xiangfei(Department of Ultrasound,the First Affiliated Hospital of Nanchang University,Nanchang 330006,Chin)

机构地区：[1]南昌大学第一附属医院超声科,江西南昌330006

出　　处：《中国医学影像学杂志》2018年第4期294-297,301,共5页Chinese Journal of Medical Imaging

摘　　要：目的利用实时剪切波弹性成像(SWE)联合灰阶超声观察不同分娩方式初产妇会阴体形态和模量的变化,探讨分娩对会阴体肌力的影响。资料与方法收集2016年12月—2017年8月南昌大学第一附属医院妇产科产后42~56d的初产妇160例,根据分娩方式不同分为剖宫产组(80例)和阴道分娩组(80例);另选择同期健康已婚未育女性100例作为未育组。利用灰阶超声和SWE技术在静息及缩肛状态下分别测量受检者会阴体深度、高度及杨氏模量,并对各组超声参数值进行分析。结果 3组受检者会阴体深度、高度收缩幅度差异均有统计学意义(P<0.05);未育组静息及缩肛状态会阴体平均杨氏模量值高于剖宫产组和阴道分娩组,剖宫产组高于阴道分娩组,差异均有统计学意义(P<0.05)。结论不同分娩方式对女性会阴体肌力造成不同程度的影响,其中阴道分娩对会阴体的损伤较明显。Purpose To observe the changes of perineal body morphology and modulus of primiparas with real-time shear wave elastography （SWE） combined with gray-scale ultrasound and to explore the influence of delivery on perineal body tension. Materials and Methods One hundred and sixty primiparas after 42 to 56 days of delivery in the Department of Gynecology and Obstetrics of the First Affiliated Hospital of Nanchang University from December 2016 to August 2017 were enrolled and divided into cesarean section group （n=80） and vaginal delivery group （n=80）. Meanwhile, 100 healthy married nulliparous women during the same period were selected as nulliparous group. Perineal body depth, height and Young＇s modulus were measured by using gray-scale sonography and SWE at resting state and retraction status. Values of each ultrasonic parameter were analyzed. Results Difference of perineal body depth and height contraction amplitude was of statistical significance among subjects in the three groups （P〈0.05）. The mean Young＇s modulus of perineal body during resting state and retraction status in nulliparous group was higher than those in the cesarean section group and vaginal delivery group, while that in cesarean section group was higher than that in vaginal delivery group. The differences were statistically significant （P〈0.05）. Conclusion Different delivery modes have different effects on female perineal body muscle, among which vaginal delivery is of more obvious damage to perineal body.

关 键 词：自然分娩 剖宫产术 产次 超声检查 多普勒 彩色 弹性成像技术 会阴 肌力 女(雌)性 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.46[医药卫生—诊断学]