经会阴盆底二维超声、实时三维超声在女性尿失禁及膀胱脱垂评估中的应用  

Application of Transperineal Pelvic Floor Two-Dimensional Ultrasound and Real-Time Three-Dimensional Ultrasound in the Evaluation of Female Urinary Incontinence and Bladder Prolapse

作　　者：王雅娟 范淑玉 卢晓雪 WANG Yajuan;FAN Shuyu;LU Xiaoxue(Department of Ultrasound Imaging,Zhengzhou Seventh People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市第七人民医院超声影像科,河南郑州450000

出　　处：《河南医学研究》2024年第3期558-562,共5页Henan Medical Research

摘　　要：目的 评估经会阴盆底二维超声、实时三维超声在女性尿失禁(UI)及膀胱脱垂中的作用。方法 选取2021年2月至2023年2月郑州市第七人民医院收治的60例UI及膀胱脱垂女性患者纳入观察组,另取同期体检盆底功能正常的60例女性纳入对照组,两组研究对象均接受经会阴盆底二维、实时三维超声检查,对比不同状态下盆膈裂孔前后径、横径、面积与肛提肌厚度,分析两种检查的诊断效能,分析对照组、UI及膀胱脱垂患者的超声图像特征。结果 与对照组比较,观察组静息、张力、缩肛状态下的盆膈裂孔前后径、横径、面积均大,肛提肌厚度小(P<0.05);与会阴盆底二维超声对比,实时三维超声对UI及膀胱脱垂的诊断准确度、敏感度、阴性预测值更高(P<0.05);两种检查方式对UI及膀胱脱垂的诊断特异度、阳性预测值差异无统计学意义(P>0.05)。盆底功能正常女性:Valsalva动作后,膀胱颈距膀胱颈与耻骨联合下缘距离为12.6 mm,膀胱尿道后角为134.25°,尿道倾斜角为28.15°。UI超声图像特征:Valsalva动作之后,膀胱颈距膀胱颈与耻骨联合下缘的距离为-15.1 mm,膀胱尿道后角为164.19°,尿道倾斜角为59.83°,尿道内口表现为“漏斗状”。膀胱脱垂超声图像特征:膀胱尿道膨出Valsalva后,膀胱颈距膀胱颈与耻骨联合下缘距离为-6.9 mm,膀胱尿道后角为146.71°,尿道倾斜角为54.87°,尿道内口未见明显开放。孤立性膀胱膨出:Valsalva后膀胱颈距膀胱颈与耻骨联合下缘距离为-10.0 mm,膀胱后壁最低点与膀胱颈与耻骨联合下缘的距离为-24.3 mm,膀胱尿道后角为82.52°,尿道倾斜角为108.55°。结论 与经会阴盆底二维超声相比,实时三维超声对女性UI及膀胱脱垂患者的诊断准确度、敏感度更高,且UI与膀胱脱垂患者的超声图像特征明显不同,实时三维超声的应用价值较高。Objective To analyze the application of transperineal pelvic floor two-dimensional ultrasound and real-time three-dimensional ultrasound in the evaluation of female urinary incontinence(UI)and bladder prolapse.Methods Sixty female patients with UI and bladder prolapse were included in the Zhengzhou Seventh People’s Hospital,who were admitted from February 2021 to February 2023 and were named as the observation group.Sixty female patients with normal pelvic floor function who underwent physical examination at the same time were also named as the control group.Both groups underwent transperineal pelvic floor two-dimensional and real-time three-dimensional ultrasound examinations.The anterior and posterior diameters,transverse diameters,areas,and thickness of the levator ani muscle of the pelvic diaphragm hiatus in different states were compared,and the diagnostic efficacy of the two examinations was analyzed,the ultrasound image features of the control group,UI,and bladder prolapse patients were analyzed.Results Compared with the control group,the observation group had a larger anterior and posterior diameter,transverse diameter,and area of the pelvic diaphragm hiatus under resting,tension,and anal constriction conditions,and a smaller thickness of the levator ani muscle(P<0.05).Compared with two-dimensional ultrasound of the perineum and pelvic floor,real-time three-dimensional ultrasound had higher diagnostic accuracy,sensitivity,and negative predictive value for UI and bladder prolapse(P<0.05).There was no statistically significant difference in the diagnostic specificity and positive predictive value between the two examination methods for UI and bladder prolapse(P>0.05).Women with normal pelvic floor function:after Valsalva’s maneuver,the distance between the bladder neck and the lower edge of the pubic symphysis was 12.6 mm,the posterior angle of the bladder urethra was 134.25°,and the inclination angle of the urethra was 28.15°.UI ultrasound image features:after Valsalva’s maneuver,the distance betwe

关 键 词：经会阴盆底二维超声 实时三维超声 女性尿失禁 膀胱脱垂 诊断效能 

分 类 号：R445.1[医药卫生—影像医学与核医学]