盆底MRI在评估前列腺癌根治术后早期尿控恢复中的作用  

The role of pelvic floor MRI in evaluating early urinary control recovery after radical prostatectomy

作　　者：吴玥 朱文[2] 王庆伟[2] 杨子涛[1] 张晨阳[2] 单帅[2] 张静[1] 程敬亮[1] 车英玉[1] WU Yue;ZHU Wen;WANG Qingwei;YANG Zitao;ZHANG Chenyang;SHAN Shuai;ZHANG Jing;CHENG Jingliang;CHE Yingyu(Department of Magnetic Resonance Imaging,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Urology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院磁共振科,河南郑州450052 [2]郑州大学第一附属医院泌尿外科,河南郑州450052

出　　处：《实用放射学杂志》2022年第3期432-436,共5页Journal of Practical Radiology

摘　　要：目的探讨腹腔镜前列腺癌根治术(LRP)前后盆底MRI检查对术后早期尿控恢复的评估作用.方法回顾性收集63例行LRP患者的临床资料以及LRP手术前、手术后3个月的MRI资料,根据术后3个月患者的尿控情况分为尿控组(23例)及尿失禁组(40例).在术前及术后盆底MRI上测量膜性尿道长度(MUL),分别标记为MUL1,MUL2,并计算术中MUL丢失率,在术后盆底MRI上测量膀胱颈与耻骨尾骨线的距离、膀胱颈与耻骨的距离,并在术后MRI上观察是否存在尿道内尿池.使用独立样本t检验(正态分布)或秩和检验(偏态分布)比较尿控组和尿失禁组患者计量资料的差异,使用χ^(2)检验比较计数资料的差异.结果MUL1、MUL2、MUL丢失率、膀胱颈与耻骨尾骨线的距离、存在尿道内尿池在2组间差异均有统计学意义(Z=-4.711、Z=-5.411、Z=-3.369、Z=-2.608、χ^(2)=13.636,P<0.05),膀胱颈与耻骨的距离在2组间差异无统计学意义(Z=-1.520,P=0.128).结论LRP手术前后盆底MRI可以观察到早期尿控恢复的患者术前及术后MUL较长,术中MUL丢失率较低,术后膀胱颈在盆腔中的位置较高且术后较少存在尿道内尿池,表明盆底MRI检查可预测LRP术后早期尿失禁的恢复情况.Objective To investigate the role of pelvic floor MRI before and after laparoscopic radical prostatectomy(LRP)in evaluating postoperative early urinary control recovery.Methods The clinical data and MRI data before and three months after operation of 63 patients who underwent LRP were retrospectively collected.According to the urinary control condition of three months after LRP,they were divided into two groups:urinary control group(n=23)and urinary incontinence group(n=40).Membranous urethral lengthes(MUL)were measured on pre-and post-operative pelvic floor MRI,marked as MUL1 and MUL2 respectively,and the intraoperative MUL loss rate was calculated.The distance between bladder neck and pubic coccyx line,the distance between bladder neck and pubic bone were measured on postoperative pelvic floor MRI.The existence of urinary pooling in urethra was observed on postoperative MRI,also.The differences of these parameters between the two groups were compared byttest(measurement data of normal distribution),rank-sumtest(measurement data of non-normal distribution)orχ^(2)test(count data).Results There were significant differences in MUL1,MUL2,the loss rate of MUL,the distance between bladder neck and pubic coccyx line,and the existence of urinary pooling in urethra between the two groups(Z=-4.711,Z=-5.411,Z=-3.369,Z=-2.608,χ^(2)=13.636,P<0.05).There was no significant difference in the distance between bladder neck and pubic bone between the two groups(Z=-1.520,P=0.128).Conclusion Longer MUL before and after LRP,lower loss rate of MUL,higher position of bladder neck in pelvic and less existence of urinary pooling in urethra can be observed on pelvic floor MRI in that patients with early urinary control recovery.It suggests that pelvic floor MRI can predict the recovery of early urinary incontinence after LRP.

关 键 词：盆底磁共振成像 腹腔镜前列腺癌根治术 尿失禁 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.25[医药卫生—诊断学] R694.54[医药卫生—临床医学]