经会阴二维联合四维超声在女性膀胱脱垂分型中的应用  

Application of transperineal two-dimensional ultrasonography combined with four-dimensional ultrasonography in the clinical classification of cystocele in female patients

作　　者：赖瑞青 陈忠 赖苑芳 李群欢[1] 杜丽婵[1] 唐荣德[1] Lai Ruiqing;Chen Zhong;Lai Yuanfang;Li Qunhuan;Du Lichan;Tang Rongde(Department of Ultrasound,Xinhui Hospital of Traditional Chinese Medicine,Jiangmen,529100,China)

机构地区：[1]广东省江门市新会区中医院超声科,广东江门529100

出　　处：《中国中西医结合影像学杂志》2019年第2期170-173,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：江门市科技局课题(江科〔2016〕104号-14)

摘　　要：目的:探讨经会阴二维联合四维超声在女性膀胱脱垂分型中的应用价值,分析不同膀胱脱垂亚型的声像图特征。方法:收集28例膀胱脱垂患者,并同期选取22例无盆腔器官脱垂和尿失禁患者作为对照。运用经会阴二维联合四维盆底超声成像技术,观察膀胱颈的移动情况,测量Valsalva动作下膀胱最低点至参考线的垂直距离、尿道旋转角及膀胱尿道后角;四维超声观察肛提肌裂孔的形态及结构改变,筛查出不同类型的膀胱脱垂。结果:28例中12例膀胱尿道膨出,16例孤立性膀胱膨出。Valsalva动作下测量参数:膀胱最低点至耻骨联合后下缘的垂直距离在膀胱脱垂与对照组之间比较差异有统计学意义(P<0.05),在不同类型膀胱脱垂之间差异无统计学意义(P> 0.05);膀胱尿道后角在膀胱尿道膨出组明显大于孤立性膀胱膨出组和对照组(均P<0.05);尿道旋转角和肛提肌裂孔面积在膀胱尿道膨出组和孤立性膀胱膨出组均明显大于对照组(均P<0.05),在不同膀胱脱垂亚型之间比较差异无统计学意义(P> 0.05)。尿道漏斗形成在膀胱尿道膨出组有9例(75.0%),在孤立性膀胱膨出组和对照组均未见。结论:经会阴二维联合四维超声可成功获得不同膀胱脱垂亚型的声像图特征,为临床鉴别诊断该病及选择最佳个性化治疗方案提供诊疗依据。Objective:To investigate the application value of transperineal two-dimensional ultrasonography combined with four-dimensional ultrasonography in the clinical classification of cystocele in female patients and the sonographic features of different subtypes of bladder prolapse.Methods:28 patients with bladder prolapse were collected,and 22 cases without urinary incontinence and pelvic organ prolapse were collected as the control group.The transperineal pelvic floor two-dimensional ultrasonography combined with four-dimensional ultrasonography imaging technology was applied for observing the mobility of bladder neck and measure the vertical distance from the lowest point to the reference line,the rotation angle of urethral and posterior vesicourethral angle under the Valsalva action;the morphological and structural changes of levator hiatus were observed via four-dimensional ultrasound for the screening of different types of bladder prolapse.Results:Among 28 cases,twelve cases of vesical urethra prolapse and sixteen cases of isolated cystocele were diagnosed with the transperineal two-dimensional ultrasonography combined with four-dimensional ultrasonography according to the position of the bladder,posterior vesicourethral angle,the rotation angle of the urethra and the internal structure change of the levator hiatus.Measured paraments in Valsalva condition:There were statistically significant differences in terms of the vertical distance from the lowest point of the bladder to the lower edge of the symphysis pubis between the bladder prolapse group and control group while there was no statistical significance between different types of bladder prolapse.The posterior vesicourethral angle of cystourethrocele was obviously greater than isolated cystocele group and control group(P<0.05);the rotation angle of the urethra and the area of levator hiatus of cystourethrocele and isolated cystocele group were significantly higher than control group(P<0.05).Moreover,there was no significant difference between different bladd

关 键 词：膀胱脱垂 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R694[医药卫生—诊断学]