经会阴二、三维超声检查盆底功能障碍性疾病患者肛提肌裂孔形态分析  

Transperineal two-and three-dimensional ultrasound examination of morphology of levator ani hiatus in patients with pelvic floor dysfunction diseases

作　　者：雷敏 刘毓 胡青青 郑静 LEI Min;LIU Yu;HU Qing-qing;ZHENG Jing(Department of Ultrasound,Garze Tibetan Autonomous Prefecture People's Hospital,Garze 626000,China)

机构地区：[1]四川省甘孜藏族自治州人民医院超声科,四川甘孜626000

出　　处：《实用医院临床杂志》2025年第2期56-60,共5页Practical Journal of Clinical Medicine

基　　金：四川省科技厅科研项目(编号:2023YFQ0006);成都市医学科研项目(编号:2022116)。

摘　　要：目的探究经会阴二、三维超声检查盆底功能障碍性疾病(pelvic floor disfunction,PFD)患者肛提肌裂孔形态。方法回顾性分析2020年4月至2023年7月我院182例PFD患者(观察组)和170例健康女性(对照组)。比较两组二维、三维超声静息及Valsalva动作下肛提肌裂孔平面测量参数,统计相关变化量与功能,分析单一及联合检测的诊断效能。结果观察组盆底前后径(APR)、盆底左右径(LRR)、肛提肌面积(AR)、盆底前后径体积(APV)、盆底左右径体积(LRV)、肛提肌体积(AV)值高于对照组(P<0.05);观察组静息状态及Valsalva动作体积均大于对照组,而形态对称占比低于对照组(P<0.05)。观察组前后径增加百分比(PIap%)、前后径变化量(△AP)、面积变化量(△A)、面积增加百分比(PIa%)值均高于对照组(P<0.05);观察组体积变化量(△V)高于对照组,均匀变化值低于对照组(P<0.05)。联合检测灵敏度91.02%、特异度89.37%,AUC为0.792,优于单一检测(P<0.05)。结论经会阴二维与三维超声联合检测对评估PFD患者肛提肌裂孔形态变化价值大,能清晰显示盆底结构,为临床诊断提供准确依据,提升诊治水平。Objective To examine the morphology of levator ani hiatus in patients with pelvic floor dysfunction diseases(PFD)through dynamic perineal ultrasonography combined with three-dimensional ultrasonography.Methods A retrospective analysis was performed on 182 patients with PFD(observation group)and 170 healthy women(control group)in our hospital from April 2020 to July 2023.The plane measurement parameters of levator hiatus under two-dimensional and three-dimensional ultrasound resting and Valsalva action were compared between the two groups.The related changes and functions were counted.The diagnostic efficacy of single and combined detection was analyzed.Results The values of pelvic floor anteroposterior diameter(APR),pelvic floor left and right diameter(LRR),levator ani muscle area(AR),pelvic floor anteroposterior diameter volume(APV),pelvic floor left and right diameter volume(LRV)and levator ani muscle volume(AV)in the observation group were higher than those in the control group(P<0.05).The resting state and Valsalva action volume were larger while the proportion of morphological symmetry of the observation were higher than those in the control group (P<0. 05). The △V of the observation group was higher than that of the control group, and the uniform change value was lower than that of the control group (P<0. 05). The sensitivity of combined detection was 91. 02%. The specificity was 89. 37 %. The AUC of ROC curve was 0. 792, which was better than that of single detection (P<0. 05). Conclusions The combined detection of perineal two-dimensional and three-dimensional ultrasound has great value in evaluating the morphological changes of levator ani hiatus in patients with PFD. It can clearly show the pelvic floor structure, provide accurate basis for clinical di-agnosis, and improve the level of diagnosis and treatment.

关 键 词：会阴二维超声 联合 三维超声 盆底功能障碍性疾病 肛提肌裂孔形态 

分 类 号：R445.1[医药卫生—影像医学与核医学]