全栈式自动盆底超声获取并测量最小肛提肌裂孔平面的可行性  

Clinical application of the full-stack smart pelvic floor ultrasound to acquire and measure the minimal levator hiatus plane

作　　者：李清莹 陈华[2] 王诗雅[2] 巫敏 郭娟[2] 陈梦华[2] 唐婵贤 梁凤婷 王慧芳 Li Qingying;Chen Hua;Wang Shiya;Wu Min;Guo Juan;Chen Menghua;Tang Chanxian;Liang Fengting;Wang Huifang(Graduate School of Guangzhou Medical University,Guangzhou 511436,China;Department of Ultrasound,Shenzhen Second People′s Hospital,Shenzhen 518035,China)

机构地区：[1]广州医科大学研究生院,广州511436 [2]深圳市第二人民医院超声科,深圳518035

出　　处：《中华超声影像学杂志》2022年第2期145-150,共6页Chinese Journal of Ultrasonography

基　　金：深圳市医疗卫生三名工程(SZSM201612027);深圳市医学重点学科(SZXK052)。

摘　　要：目的探讨全栈式自动盆底超声(FSPFU)软件获取并测量盆底最小肛提肌裂孔(LH)平面的临床应用可行性。方法选取2020年11月至2021年1月在深圳市第二人民医院行盆底超声检查的119例产后6个月内的女性为研究对象, 其中包括膀胱膨出0~Ⅰ度17例、Ⅱ度68例、Ⅲ度34例。经会阴采集患者在静息状态下以盆底正中矢状切面为初始切面的三维容积图并储存在机器中。由4名医生手动调节三维容积数据图获取并测量最小LH平面(其中2名低年资医生为D1组、2名高年资医生为D2组), 另由1名低年资医生用FSPFU软件一键获取并测量最小LH平面(D3组), 测量参数包括:最小LH的面积、周长、前后径、左右径、左侧肛提肌尿道间隙和右侧肛提肌尿道间隙。记录每组获取并测量最小LH平面所用的时间及测量的结果, 并离线计算三组间最小LH轮廓的重合率。另由2名高年资医生A、B对所获取的LH图像进行独立线下评分。结果在不同膀胱膨出程度下, D3组获取并测量最小LH平面的时间明显短于D1组和D2组, D2组明显短于D1组(平均时间:D1为82.97 s, D2为62.51 s, D3为2.71 s, 均P<0.05)。三组测量的最小LH平面面积的组间一致性、相关性较好(均ICC>0.85, rs>0.70, P<0.001)。三组描绘的最小LH轮廓高度重合(重合率均>92%), 且三组的LH图像评分差异无统计学意义(均P>0.05)。结论 FSPFU软件能快速准确地自动获取并测量最小LH平面, 帮助超声医师提高盆底超声检查的效率, 可成为临床上辅助诊断盆底功能障碍性疾病的有效工具, 推动盆底超声在临床上的广泛应用。Objective To evaluate the feasibility of Full-stack Smart Pelvic Floor Ultrasound(FSPFU)software in the acquisition and measurement of the minimal levator hiatus(LH).Methods Transperineal pelvic floor ultrasonography was performed in 119 women of 6-month postpartum from Nov.2020 to Jan.2021 of Shenzhen Second People′s Hospital.Mid-sagittal plane of pelvic floor was set as the initial plane,and the three-dimensional volume data was acquired.The dataset was stored in the machine.The offline volume data was manually adjusted to obtain the minimal LH images and measured by four physicians(two junior physicians as the D1 group and two senior physicians as the D2 group).For comparison,the results were also obtained using the fully automated method—the FSPFU software by a junior physician(the D3 group).The obtained parameters of minimal LH included area,circumference,anterioposterior diameter,transverse diameter,left and right levator-urethral gap distance.Analysis time was recorded for each group.The contours of minimal LH were outlined by three groups and the overlapping rate was calculated.The quality of the resulted images was evaluated and scored by another two senior physicians(A and B)independently.Results The D3 group had a significant shorter analysis time compared with the other two groups,and the D1 group took a longer time than the D2 group,regardless of the cystocele severity(D1:82.97 s,D2:62.51 s,D3:2.71 s,all P<0.05).The intergroup agreements and correlations of the minimum LH area were good(all ICC>0.85,rs>0.70,P<0.001)and the outlined contours were largely overlapped(>92%).There was no significant difference in image quality among the three groups(all P>0.05).Conclusions FSPFU software can automatically obtain and measure the minimum LH in an efficient and accurate way,which can improve the effectiveness of the present pelvic floor examination.FSPFU software can be an useful tool in the diagnosis of pelvic floor dysfunctional diseases.

关 键 词：自动盆底超声 肛提肌裂孔 盆腔器官脱垂 膀胱膨出 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711.2[医药卫生—诊断学]