阴道穹隆脱垂的临床检查和动态磁共振成像诊断  

Clinical examination and dynamic magnetic resonance imaging in vaginal vault prolapse

作　　者：Cortes E. Reid W.M.N. Singh K. Berger L. 马向东 

机构地区：[1]Royal Free Hospital,Acad.Dept.Ob-stet.and Gynecolog y,Pond Street,Hampstead,London NW32QG,United King dom Dr.

出　　处：《世界核心医学期刊文摘（妇产科学分册）》2005年第2期59-60,共2页Core Journal in Obstetrics/Gynecology

摘　　要：OBJECTIVE:To estimate the role of dynamic magnetic resonance imaging(MRI )as a diagnostic tool in the eval-uation of vaginal apex prolapse in wo men with previous hysterectomy.METHODS:Clinical examinations were performed on 51women presenting wit h symptoms of pro-lapse.A preoperative dynamic MRI assessment was per-formed.The mid pubic line was the reference level used for prolapse grading.The parameters of analysis included 1)correlation by compartments of clin ical and MRI grading of prolapse,2)assessment of the accuracy of clinic al exami-nation of the middle compartment,an d 3)identification of any additional information provided by MRI.AllMRI films were analyzed and validated by the sa me two observers.RESULTS:Analysis of each compartme nt separately re-vealed poor correlation between cli nical and MRI assess-ment Of the 51cases with clinical vau lt prolapse,27(52.9%)cases were clinically overdiagnose d,3(6%)were underdiagnosed,and there was a greement in 21(41.1%)when compared with MRI findings.Postopera-tive follow -up of the 18(85%)patients who underwent colposacropexy after intraoperati ve assessment revealed the presence of cystocele in 4(26.6%)occasions and recto-cele in 3(20%),which had been detected on MRI but not confirmed intraoperatively.CONCLUSION:There is poor correlation between clinical and MRI findings when as-sessing vaginal apex prolapse.Magn etic resonance imaging allows the identification of other p rolapsing compartments and may be a complementary diagnostic tool for the diag-nosis of complex vaginal apex prolap se.OBJECTIVE:To estimate the role of dynamic magnetic resonance imaging(MRI )as a diagnostic tool in the eval-uation of vaginal apex prolapse in wo men with previous hysterectomy.METHODS:Clinical examinations were performed on 51women presenting wit h symptoms of pro-lapse.A preoperative dynamic MRI assessment was per-formed.The mid pubic line was the reference level used for prolapse grading.The parameters of analysis included 1)correlation by compartments of clin ical and MRI grading of prolapse,2)assessment of the accuracy of clinic al exami-nation of the middle compartment,an d 3)identification of any additional information provided by MRI.AllMRI films were analyzed and validated by the sa me two observers.RESULTS:Analysis of each compartme nt separately re-vealed poor correlation between cli nical and MRI assess-ment Of the 51cases with clinical vau lt prolapse,27(52.9%)cases were clinically overdiagnose d,3(6%)were underdiagnosed,and there was a greement in 21(41.1%)when compared with MRI findings.Postopera-tive follow -up of the 18(85%)patients who underwent colposacropexy after intraoperati ve assessment revealed the presence of cystocele in 4(26.6%)occasions and recto-cele in 3(20%),which had been detected on MRI but not confirmed intraoperatively.CONCLUSION:There is poor correlation between clinical and MRI findings when as-sessing vaginal apex prolapse.Magn etic resonance imaging allows the identification of other p rolapsing compartments and may be a complementary diagnostic tool for the diag-nosis of complex vaginal apex prolap se.

关 键 词：磁共振成像诊断 阴道穹隆 阴道固定术 检查和 动态磁共振成像 临床病变 参考水平 鉴别诊断 临床评定 膀胱膨出 

分 类 号：R711.2[医药卫生—妇产科学]