Minimal criteria for the diagnosis of avulsion of the puborectalis muscle by tomographic ultrasound
Minimal criteria for the diagnosis of avulsion of the puborectalis muscle by tomographic ultrasound
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DOI：
10.1007/s00192-010-1329-4
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发表时间：
2011-06-01
影响因子：
1.8
通讯作者：
Shek, Ka Lai
中科院分区：
文献类型：
--
作者：
Dietz, Hans Peter;Bernardo, Maria Jose;Shek, Ka Lai
耻骨直肠肌撕脱伤可能是女性盆腔器官脱垂的病因之一。我们进行了一项研究，以建立诊断撕脱的最低超声标准。我们分析了764名在泌尿外科就诊的女性的数据集。超声数据集的离线分析是在对患者数据盲的情况下执行的。应用断层超声成像(TUI)诊断耻骨直肠肌撕脱伤，对TUI数据进行Logistic回归分析，发现3层螺旋CT断层片异常是诊断完全性撕脱伤的最佳方法。这一发现是在30%的患者中获得的，并与FPOP的症状和体征有关(P<；0.001)。创伤程度较轻(‘部分撕脱’)与盆底功能障碍的症状或体征无关。耻骨直肠肌完全撕脱的最佳诊断是TUI，要求所有三个中央切片均异常。部分创伤的临床相关性似乎有限。
Puborectalis avulsion is a likely etiological factor for female pelvic organ prolapse (FPOP). We performed a study to establish minimal sonographic criteria for the diagnosis of avulsion.We analysed datasets of 764 women seen at a urogynecological service. Offline analysis of ultrasound datasets was performed blinded to patient data. Tomographic ultrasound imaging (TUI) was used to diagnose avulsion of the puborectalis muscle.Logistic regression modelling of TUI data showed that complete avulsion is best diagnosed by requiring the three central tomographic slices to be abnormal. This finding was obtained in 30% of patients and was associated with symptoms and signs of FPOP (P < 0.001). Lesser degrees of trauma ('partial avulsion') were not associated with symptoms or signs of pelvic floor dysfunction.Complete avulsion of the puborectalis muscle is best diagnosed on TUI by requiring all three central slices to be abnormal. Partial trauma seems of limited clinical relevance.