子宫脱垂患者术前及术后盆底支持结构的磁共振成像评价  

MRI evaluation of preoperative and postoperative pelvic floor support structures in patients with uterine prolapse

作　　者：杨洁 李小丽 孙惠苗 胡磊 Yang Jie;Li Xiaoli;Sun Huimiao;Hu Lei(Department of MRI,Children Hospital of Shanxi Province,Shanxi Maternal and Children Health Care Hospital,Taiyuan Shanxi 030013,China;Department of Gynaecology and Obstetrics,Children Hospital of Shanxi Province,Shanxi Maternal and Children Health Care Hospital,Taiyuan Shanxi 030013,China)

机构地区：[1]山西省儿童医院(山西省妇幼保健院)磁共振室,山西太原030013 [2]山西省儿童医院(山西省妇幼保健院)妇产科,山西太原030013

出　　处：《实用医技杂志》2023年第1期12-15,共4页Journal of Practical Medical Techniques

基　　金：山西省儿童医院(山西省妇幼保健院)科研项目(201951)。

摘　　要：目的探讨子宫脱垂(UP)患者术前及经阴全子宫切除术并阴道骶棘韧带悬吊术(SSLF)后盆底支持结构的磁共振成像(MRI)影像特征变化,为临床医师制定个体化的诊疗措施提供依据。方法选取在山西省儿童医院诊断为Ⅱ°~Ⅳ°UP需手术治疗、且在术前和术后均行MRI检查的患者29例。手术前、后于静息位和Valsalva动作时进行盆底MRI扫描。采用相关软件分别测量H线、M线、G1角、G2角、宫颈长度、B线、C线等参数值。结果术前静息位UPⅣ°患者的宫颈长度长于Ⅱ°~Ⅲ°患者(t=2.414,P=0.019);Valsalva动作位Ⅳ°患者H线、M线、G1角、G2角、B线和C线均高于Ⅱ°~Ⅲ°患者,差异有统计学意义[H线(t=2.378,P=0.021)、M线(t=5.299,P<0.01)、G1角(t=4.592,P<0.01)、G2角(t=2.147,P=0.036)、B线(t=2.190,P=0.032)和C线(t=2.150,P=0.036]。Ⅱ~Ⅳ期患者手术后3个月复查发现,H线、M线、G1角、G2角均较术前改善,差异有统计学意义,其中H线(t=6.658,13.221;P<0.01)、M线(t=13.111,18.583;P<0.01)、G1角(t=6.408,7.905;P<0.01)、G2角(t=2.239,7.469;P=0.027)。结论盆底MRI扫描可以清晰显示子宫脱垂患者的盆底支持结构,有助于子宫脱垂的诊断和手术疗效判断。Objective To investigate the MRI characteristics of pelvic floor support structure after suspension(SSLF)for patients with uterine prolapse(UP),so as to provide a reliable basis for clinicians to develop individualized diagnosis and treatment measures.Methods Twenty-nine patients were selected who were diagnosed with degreeⅡ°~Ⅳ°UP in Children Hospital of Shanxi Province and underwent MRI before and after surgery.Pelvic floor MRI scans were performed before and after the resting position and in Valsalva movements.The parameter values of H line,M line,G1 angle,G2 angle,cervical length,B line and C line were measured by relevant software.Results The cervical length of patients with UP IV°was significantly longer than those withⅡ-Ⅲ°(t=2.414,P=0.019).In Valsalva movements,patients with UP IV°had significantly higher H line(t=2.378,P=0.021),M line(t=5.299,P<0.01),G1 angle(t=4.592,P<0.01),G2 angle(t=2.147,P=0.036),B line(t=2.190,P=0.032)and C line(t=2.150,P=0.036)than patients withⅡ°-Ⅲ°(all P<0.05).Three months after the operation,it was found that H line(t=6.658,13.221;P<0.01),M line(t=13.111,18.583;P<0.01),G1 angle(t=6.408,7.905;P<0.01)and G2 angle(t=2.239,7.469;P=0.027)were significantly improved compared with the preoperative results(P<0.01).Conclusion Pelvic floor MRI scan can clearly show the pelvic floor support structure in patients with uterine prolapse,which is helpful for the diagnosis and judgment of surgical efficacy of uterine prolapse.

关 键 词：子宫脱垂 盆底疾病 磁共振成像 盆底支持结构 

分 类 号：R713.4[医药卫生—妇产科学]