肛提肌相关高分辨率MRI参数在评估子宫脱垂程度中的应用价值  

The application value of the parameters related to levator ani of high-resolution MRI in evaluating the degree of uterine prolapse

作　　者：王倩 毕国力[2] 毕秋 陈渝晖[2] 龚霞蓉[2] 郑轶珺 WANG Qian;BI Guoli;BI Qiu;CHEN Yuhui;GONG Xiarong;ZHENG Yijun(School of Medical,Kunming University of Science and Technology,Kunming 650500,China;Department of MRI,the First People's Hospital of Yunnan Province,Kunming 650032,China)

机构地区：[1]昆明理工大学医学院,云南昆明650500 [2]云南省第一人民医院磁共振科,云南昆明650032

出　　处：《实用放射学杂志》2023年第8期1306-1309,1345,共5页Journal of Practical Radiology

基　　金：云南省科技厅-昆明医科大学应用基础研究联合专项面上项目(202001AY070001-110)。

摘　　要：目的探讨肛提肌的MRI参数与子宫脱垂程度的相关性并评估其在临床非显著性子宫脱垂中的诊断价值。方法选取子宫脱垂患者129例,行盆底MRI检查,测量不同程度子宫脱垂患者肛提肌的MRI参数,分析各参数与子宫脱垂程度的相关性,构建各参数联合诊断临床非显著性子宫脱垂的logistic回归模型,并分析各参数及联合参数评估临床非显著性子宫脱垂的诊断效能。结果不同程度子宫脱垂患者的肛提肌裂孔面积(HA)、前后径(AP)、横径(LR)和左侧肛提肌耻骨间隙(LSG-L)的差异有统计学意义(P<0.05),其余参数差异无统计学意义(P≥0.05)。HA、AP、LR、耻骨直肠肌附着宽度(PAW)和双侧LSG与子宫脱垂程度呈正相关(r=0.181~0.502,P<0.05),提肛板角(LPA)与子宫脱垂程度无明显相关性(r=-0.050,P>0.05)。HA、AP、LR、PAW和双侧LSG在临床非显著性子宫脱垂与显著性子宫脱垂之间的差异均有统计学意义(P<0.05),LPA在两者之间的差异无统计学意义(P>0.05)。HA、AP、LR、双侧LSG及联合参数诊断临床非显著性子宫脱垂的受试者工作特征(ROC)曲线的曲线下面积(AUC)均>0.70,PAW诊断临床非显著性子宫脱垂的AUC为0.677。结论肛提肌相关MRI参数与子宫脱垂程度相关,除LPA外各参数均能有效诊断临床非显著性子宫脱垂,以联合参数诊断效能最佳。Objective To investigate the correlation between the MRI parameters of levator ani and the degree of uterine prolapse,and to evaluate the diagnostic value of MRI parameters in the clinically non-significant uterine prolapse.Methods A total of 129 patients with uterine prolapse were selected.All patients underwent pelvic floor MRI examination.MRI parameters of levator ani in patients with different degrees of uterine prolapse were measured.The correlation between each parameter and the degree of uterine prolapse was analyzed,and a logistic regression model for the combined diagnosis of clinically non-significant uterine prolapse with various parameters was established,and the diagnostic efficacy of each parameter and combined parameter in evaluating clinically non-significant uterine prolapse was assessed.Results There were significant differences in levator ani hiatus area(HA),anteroposterior diameter(AP),left-right diameter(LR),levator symphysis gap of left(LSG-L)among patients with different degrees of uterine prolapse(P<0.05),while there were no significant differences in other parameters(P≥0.05).HA,AP,LR,puborectalis attachment width(PAW),and bilateral LSG were positively correlated with the degree of uterine prolapse(r=0.181-0.502,P<0.05),while levator ani plate angle(LPA)was not significantly correlated with the degree of uterine prolapse(r=-0.050,P>0.05).There were significant differences in HA,AP,LR,PAW,and bilateral LSG between the patients with clinically non-significant uterine prolapse and the patients with significant uterine prolapse(P<0.05),while there was no significant difference in LPA between the two groups(P>0.05).The area under the curve(AUC)of HA,AP,LR,bilateral LSG,and combined parameter for diagnosing clinically non-significant uterine prolapse were greater than 0.70,and the AUC of PAW was 0.677.Conclusion MRI parameters related to levator ani are correlated with the degree of uterine prolapse.All parameters except LPA can effectively diagnose clinically non-significant uterine prolapse,

关 键 词：肛提肌 子宫脱垂 高分辨率磁共振成像 

分 类 号：R711.23[医药卫生—妇产科学] R445.2[医药卫生—临床医学]