Pelvic floor dysfunction: assessment with combined analysis of static and dynamic MR imaging findings.
Pelvic floor dysfunction: assessment with combined analysis of static and dynamic MR imaging findings.
复制标题
盆底功能障碍：结合静态和动态 MR 成像结果分析进行评估。
作者：
R. E. El Sayed;Sahar El Mashed;A. Farag;M. Morsy;M. A. Abdel Azim
目的
前瞻性地同时分析静态和动态磁共振(MR)图像，以确定压力性尿失禁(SUI)、盆腔器官脱垂(POP)和肛门失禁是否与特定的盆底异常相关。
材料和方法
这项研究得到了机构审查委员会的批准，并获得了所有参与者的知情同意。共59例，其中未产妇对照组15例(平均年龄25.6岁)，患者44例(平均年龄43.4岁)，按主要症状分为4组。使用静态T2加权自旋回波图像评估结构紊乱；使用功能动态(CINE)平衡快速场回波图像检测功能异常并记录支撑结构的5个测量值。两种类型的磁共振图像的结果被分析在一起以确定主要的缺陷。组间比较采用方差分析和Bonferroni t检验。
结果
在4组患者中，POP合并提肌无力16例(47%)，合并I、II级筋膜缺损7例(21%)，合并两种程度筋膜缺损11例(32%)。29例患者中有25例(86%)伴有尿路支撑结构缺陷，但与膀胱颈下沉无关。在没有肛门括约肌缺陷的情况下，提肌无力可能导致肛门失禁。支撑结构的测量在确定盆底松弛方面有重要意义(P<；0.05)。
结论
结合分析盆底功能障碍患者的静态和动态磁共振图像，可以识别具有特定功能障碍的某些结构异常。
PURPOSE
To prospectively analyze static and dynamic magnetic resonance (MR) images simultaneously to determine whether stress urinary incontinence (SUI), pelvic organ prolapse (POP), and anal incontinence are associated with specific pelvic floor abnormalities.
MATERIALS AND METHODS
This study had institutional review board approval, and informed consent was obtained from all participants. There were 59 women: 15 nulliparous study control women (mean age, 25.6 years) and 44 patients (mean age, 43.4 years), who were divided into four groups according to chief symptom. Static T2-weighted turbo spin-echo images were used in evaluating structural derangements; functional dynamic (cine) balanced fast-field echo images were used in detecting functional abnormalities and recording five measurements of supporting structures. Findings on both types of MR images were analyzed together to determine the predominant defect. Analysis of variance and the Bonferroni t test were used to compare groups.
RESULTS
In the four patient groups, POP was associated with levator muscle weakness in 16 (47%) of 34 patients, with level I and II fascial defects in seven (21%) of 34 patients, and with both defects in 11 (32%) of 34 patients. SUI was associated with defects of the urethral supporting structures in 25 (86%) of 29 patients but was not associated with bladder neck descent. Levator muscle weakness may lead to anal incontinence in the absence of anal sphincter defects. Measurements of supporting structures were significant (P < .05) in the identification of pelvic floor laxity.
CONCLUSION
Combined analysis of static and dynamic MR images of patients with pelvic floor dysfunction allowed identification of certain structural abnormalities with specific dysfunctions.