盆底超声测量前腔室结构参数及静、动态MRI在初产妇产后压力性尿失禁诊断及防治中的应用观察  

Application of pelvic floor ultrasound measurement of anterior chamber structural parameters and static and dynamic MRI in diagnosis,prevention and treatment of postpartum SUI in primipara

作　　者：马春燕[1] 魏珊[1] 符叶柳[1] MA Chun-yan;WEI Shan;FU Ye-liu(Department of Ultrasound,Central South University Xiangya School of Medicine Affiliated Haihou Hospital,Haihou 570208,China)

机构地区：[1]中南大学湘雅医学院附属海口医院超声医学科,海南海口570208

出　　处：《中国临床医学影像杂志》2022年第3期210-215,共6页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨盆底超声测量前腔室结构参数及静、动态MRI在初产妇产后压力性尿失禁(SUI)诊断及防治中的应用价值。方法:选取2020年1—12月本院产科进行经阴道分娩并在产后回院复查的初产妇作为研究对象,分为SUI组和对照组,SUI组应用MRI进行动、静态检查LHA、H线、M线、B-PCL、U-PCL、RVA、AUA、LPA、D、S等指标,对照组应用超声进行动、静态检查BDT、UTA、RVA、B-PCL、BND、URA、D等指标,并采用ROC曲线分析超声联合MRI诊断SUI的效能。结果:①静态MRI检测发现SUI组LHA、RVA水平明显高于对照组,而B-PCL、D、S水平明显低于对照组(P<0.05);②静态超声检测发现SUI组UTA、RVA水平均高于对照组,而B-PCL水平低于对照组(P<0.05);③动态MRI检测发现SUI组LHA、H线、M线、RVA、AUA、LPA均高于对照组,而B-PCL、U-PCL、D、S均低于对照组(P<0.05);④动态超声检测发现SUI组BND、URA水平均高于对照组,而D水平低于对照组(P<0.05);⑤动态时超声检测尿道内口漏斗形成情况显示SUI组尿道内口漏斗形成率(58.69%)和膀胱膨出率(73.91%)均高于对照组(27.78%、24.07%)(P<0.05);⑥超声联合MRI检测的ROC曲线下面积明显大于单独应用超声检测(P<0.05)。结论:肛提肌功能下降、膀胱颈闭合完整性欠缺、尿道活动性升高、尿道内口括约肌功能降低、尿道膀胱漏斗发生率增加,是导致初产妇产后SUI的主要原因,临床应用超声联合MRI对患者进行检查,诊断效能高。Objective:To investigate the application value of pelvic floor ultrasound measurement of anterior chamber structural parameters and static and dynamic MRI in the diagnosis,prevention and treatment of stress urinary incontinence(SUI)in primipara.Methods:The primiparas who delivered vaginally in our hospital from January to December 2020 were selected and divided into SUI group and control group.MRI,LHA,H-line,M-line,B-PCL,U-PCL,RVA,AUA,LPA,D,S and other indicators were used in SUI group,while ultrasound,BDT,UTA,RVA,B-PCL,BND,S and other indicators were used in control group.The ROC curve was used to analyze the efficacy of ultrasound combined with MRI in the diagnosis of SUI.Results:The levels of LHA and RVA in SUI group were significantly higher than those in control group,while the levels of B-PCL,D and S in SUI group were significantly lower than those in control group(P<0.05).The levels of UTA and RVA in SUI group were higher than those in control group,while the level of B-PCL in SUI group was lower than that in control group(P<0.05).Dynamic MRI showed that LHA,H-line,M-line,RVA,AUA and LPA in SUI group were higher than those in control group,while B-PCL,U-PCL,D and S in SUI group were lower than those in control group(P<0.05).The levels of BND and URA in SUI group were higher than those in control group,while the level of D in SUI group was lower than that in control group(P<0.05).Dynamic ultrasound examination of the formation of urethral funnel showed that the forma-tion rate of urethral funnel(58.69%)and cystocele rate(73.91%)in SUI group were higher than those in control group(27.78%and 24.07%)(P<0.05).The area under ROC curve of ultrasound combined with MRI was significantly larger than that of ultra-sound alone(P<0.05).Conclusion:The main causes of postpartum SUI in primipara are the decline of levator ani muscle function,the lack of bladder neck closure integrity,the increase of urethral activity,the decrease of internal urethral sphincter function and the increase of incidence of urethral bladder fun

关 键 词：尿失禁 压力性 磁共振成像 

分 类 号：R694.54[医药卫生—泌尿科学] R445.2[医药卫生—外科学]