640层CT动态评估压力性尿失禁及盆腔脏器脱垂的研究  

Dynamic evaluation of stress urinary incontinence and pelvic organ prolapse by 640 slice CT

作　　者：赵永先[1,2] 杨博伟 苏云杉[3] Prashant Mishra[1] 陈韬 毛崇文[3] 刘建和[1] 张海燕[1] 郭海翔[1] 王家平[4] 刘攀[2] 方克伟 ZHAO Yongxian;YANG Bowei;SU Yunshan;Prashant Mishra;CHEN Tao;MAO Chongwen;LIU Jianhe;ZHANG Haiyan;GUO Haixiang;WANG Jiaping;LIU Pan;FANG Kewei(Department of Urology,Second Hospital of Kunming Medical University,Kunming,650101,China;Department of Urology,People's Hospital of Chenggong Distric;Department of Imaging,fourth Hospital of Kunming Medical University;Department of Imaging,Second Hospitalof Kunming Medical University)

机构地区：[1]昆明医科大学第二附属医院泌尿外科,昆明650101 [2]昆明市呈贡区人民医院泌尿外科 [3]昆明医科大学第四附属医院影像科 [4]昆明医科大学第二附属医院影像科

出　　处：《临床泌尿外科杂志》2020年第5期361-366,共6页Journal of Clinical Urology

基　　金：云南省科技厅项目(No:2011FZ125);云南省中青年学术和技术带头人后备人才项目(No:2017HB038);云南省卫生和计划生育委员会医学学科带头人项目(No:D-201615);昆明医科大学下尿路及盆底功能障碍科技创新团队(No:CXTD201608)。

摘　　要：目的:女性压力性尿失禁(FSUI)和盆腔脏器脱垂(POP)是中老年女性常见的问题,本研究为了探讨640层螺旋CT(640-MSCT)诊断FSUI和POP的可能性。方法:本研究招募了62例FSUI患者(SUI组)、96例POP患者(POP组)和50例健康女性志愿者(对照组)进行640-MSCT骨盆扫描。所有志愿者和患者在排尿前、排尿时和排尿后进行扫描,然后用640-MSCT扫描图像重建3D和4D图像,由2名放射科医师进行复查。通过观察这些图像,我们测量并比较了每个时期的耻骨尾骨线(PCL)、H线、M线、PCL到膀胱颈(PCL-BN)、PCL到宫颈(PCL-c)、尿道倾斜角(UIA)和膀胱尿道后角(PUVA)。结果:本研究比较了志愿者和患者(SUI患者和POP患者)的结果。实验组和对照组中的生育状况和BMI比较差异无统计学意义(P>0.05)。结果表明,各组H线、M线排尿前、排尿及排尿后比较差异均有统计学(P<0.01,P<0.05)。各组排尿时PCL-BN和PCL-C均降低。SUI组和POP组中部分受试者排尿前PCL-BN在PCL线以下,排尿时更加明显。排尿时,POP组中PCL-C明显下降。对照组的UIA和PUVA对比SUI组和POP组在排尿时差异有统计学意义(P<0.05)。结论:采用640-MSCT的3D和4DCT图像进行SUI和POP诊断是一种敏感且具体可行的方法。Objective:Female stress urinary incontinence(FSUI)and pelvic organ prolapse(POP)are common problems for adult females.This article is aimed at exploring the possibility of using 640-Multislice CT(640-MSCT)in diagnosing the FSUI and POP.Method:We recruited 62FSUI patients(SUI group),96POP patients(POP group)and 50healthy female volunteers(control group)to do the pelvis scan by 640-MSCT.All the volunteers and patients had been scanned in the period of pre-voiding,voiding and post-voiding,then 3Dand 4Dimages were reconstructed from 640-MSCT scanning images and reviewed by two radiologists.By observing these images,we measured and compared the pubococcygeal line(PCL),H line,M line,length from PCL to bladder neck(PCL-BN)and cervix(PCL-C),urethral inclined angle(UIA)and posterior urethrovesical angle(PUVA)in every period.Result:We compared between the results of volunteers and the results of patients(SUI patients and POP patients).The difference in fertility status or BMI between experiment groups and control group showed no statistical significance(P>0.05).H line and M line showed statistical difference in pre-voiding,voiding and postvoiding period between experiment groups and control group(P<0.01,P<0.05).PCL-BN and PCL-C decreased when voiding in each group.In some candidates of SUI and POP group,PCL-BN was below the bladder neck before voiding,and it was getting worse when voiding.PCL-C decreased significantly in POP group when voiding.UIA and PUVA had statistical difference between control group and SUI group and POP group when voiding.Conclusion:It is a sensitive and specific method to diagnose SUI and POP according to 3Dand 4DCT images using 640-MSCT.

关 键 词：盆底功能障碍性疾病 压力性尿失禁 盆底脏器脱垂 640层CT 

分 类 号：R694[医药卫生—泌尿科学]