Paradoxical puborectalis syndrome on diffusion-weighted imaging: a retrospective study of 72 cases.
Paradoxical puborectalis syndrome on diffusion-weighted imaging: a retrospective study of 72 cases.
复制标题
弥散加权成像反常耻骨直肠肌综合征：72例回顾性研究
DOI：
10.1038/s41598-017-03127-8
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发表时间：
2017-06-07
影响因子：
4.6
通讯作者：
Wu G
中科院分区：
文献类型：
--
作者：
Liu G;Cui Z;Dai Y;Yao Q;Xu J;Wu G
探讨弥散加权成像（DWI）在梗阻性排便综合征（ODS）患者耻骨直肠肌反常综合征（PPS）诊断中的应用价值。回顾性分析72例ODS患者的磁共振（MR）-DWI和MR-排粪造影的病历。比较PPS（+）和PPS（-）组之间的表观扩散系数（ADC）和耻骨直肠肌左右支厚度的差异。此外，还比较了两组之间左右支的绝对患者内差异（ADC，厚度）。两组之间ADC（右分支-左分支）的绝对差异有显著性差异。无论是通过单ROI（0.10 ± 0.08 vs 0.23 ± 0.18，P = 0.000）还是多ROI（0.16 ± 0.14 vs 0.27 ± 0.17，P = 0.009）分析获得ADC，PPS（+）患者的绝对ADC差异均低于PPS（-）患者。但两组间ADC值、厚度及厚度绝对差差异无统计学意义。结果提示，DWI对ODS患者耻骨直肠肌的定量评价有一定价值，而耻骨直肠肌厚度在此方面的价值有待进一步研究。
This study aimed to evaluate the application value of diffusion-weighted imaging (DWI) for assessing paradoxical puborectalis syndrome (PPS) in patients with obstructive defecation syndrome (ODS). The medical records of 72 ODS patients who underwent magnetic resonance (MR)-DWI and MR-defecography were retrospectively reviewed. The differences in the apparent diffusion coefficients (ADCs) and the thickness of the right and left branches of the puborectalis muscles between the PPS(+) and PPS(−) groups were compared. In addition, the absolute within-patient differences between the right and left branches (ADC, thickness) were compared between the two groups. The absolute difference in ADCs (right branch - left branch) was significantly different between the two groups. Regardless of whether the ADC was acquired through single-ROI (0.10 ± 0.08 vs 0.23 ± 0.18, P = 0.000) or multi-ROI (0.16 ± 0.14 vs 0.27 ± 0.17, P = 0.009) analysis, the PPS(+) patients displayed a lower absolute ADC difference than did the PPS(−) patients. However, there was no statistically significant difference in the ADC value, thickness or the absolute difference in thickness between the two groups. These findings suggest that DWI may have value in quantitatively assessing the puborectalis muscle in ODS patients, whereas the value of puborectalis thickness in such aspect needs further study.