MR排粪造影在盆底器官脱垂合并压力性尿失禁诊断中的临床应用价值  

The clinical application value of MR defecography in the diagnosis of pelvic organ prolapse with concomitant stress urinary incontinence

作　　者：李敏[1] 王素美[2] 刘童瞳 李向南[1] LI Min;WANG Sumei;LIU Tongtong;LI Xiangnan(Department of Radiology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China;Department of Gynecology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院放射科,北京100020 [2]首都医科大学附属北京朝阳医院妇产科,北京100020

出　　处：《实用放射学杂志》2024年第10期1653-1657,共5页Journal of Practical Radiology

基　　金：北京市属医院科研培育计划项目(PX2020015)。

摘　　要：目的评估磁共振排粪造影(MRD)在中、重度盆底器官脱垂(POP)合并压力性尿失禁(SUI)中的诊断效能。方法前瞻性选取Ⅱ度及以上POP患者,分为合并SUI组和单纯POP组。分析2组间盆底功能异常的影像征象,明确具有诊断价值的MRD参数,评估MRD对POP合并SUI的诊断效能。结果POP患者99例,单纯POP组42例,合并SUI组57例。2组间比较示尿道及膀胱功能均有显著性差异,膀胱颈位置(1.61 cm±1.03 cm vs 2.13 cm±0.71 cm)、膀胱后壁位置(4.13 cm±2.46 cm vs 5.23 cm±2.21 cm)、尿道轴角度(94.22°±35.62°vs 114.28°±35.55°)、关闭尿道长度(2.28 cm±0.90 cm vs 2.15 cm±0.65 cm)及膀胱颈漏斗样改变(23.81%vs 45.61%)均有统计学差异(P<0.05)。多参数MRD诊断SUI的曲线下面积(AUC)为0.73,MRD联合临床病史的AUC为0.95。结论POP合并SUI具有特征性MRD征象,MRD技术可辅助临床完善中、重度POP合并SUI的术前诊断。Objective To evaluate the diagnostic efficacy of magnetic resonance defecography(MRD)in moderate or severe pelvic organ prolapse(POP)complicated with stress urinary incontinence(SUI).Methods Patients with gradeⅡor above POP were prospectively selected,and divided into POP combined with SUI group and isolated POP group.The MRD parameters of pelvic dysfunction between groups were analyzed to clarify the clinical diagnostic value and to evaluate the diagnostic efficacy of MRD in POP combined with SUI.Results This study enrolled 99 POP patients,42 patients in isolated POP group,and 57 patients in POP combined with SUI group.The comparison between groups showed there were significant differences in the function of the urethra and bladder,including the position of the urethro-vesical junction(1.61 cm±1.03 cm vs 2.13 cm±0.71 cm),the position of the posterior bladder wall(4.13 cm±2.46 cm vs 5.23 cm±2.21 cm),the urethra angle(94.22°±35.62°vs 114.28°±35.55°),the length of the closed urethra(2.28 cm±0.90 cm vs 2.15 cm±0.65 cm),and bladder funneling(23.81%vs 45.61%),all the differences were statistically significant(P<0.05).The area under the curve(AUC)of multiple parameters MRD in the diagnosis of SUI was 0.73.The AUC in diagnosis of SUI by MRD combined with clinical history was 0.95.Conclusion POP combined with SUI has characteristic MRD signs.MRD technology can assist clinicians and improve the preoperative diagnosis rate of moderate and severe POP combined with SUI.

关 键 词：磁共振排粪造影 压力性尿失禁 盆底器官脱垂 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]