Pelvic floor morphology in the standing position using upright computed tomography: age and sex differences
Pelvic floor morphology in the standing position using upright computed tomography: age and sex differences
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DOI：
10.1007/s00192-020-04335-z
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发表时间：
2020-06-04
影响因子：
1.8
通讯作者：
Jinzaki, Masahiro
中科院分区：
文献类型：
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作者：
Narita, Keiichi;Yamada, Yoshitake;Jinzaki, Masahiro
简介和假设本研究旨在使用直立计算机断层扫描（CT）比较站立位和仰卧位之间的盆底参数，并评估性别和年龄对正常健康志愿者的影响。方法 总共 139 名志愿者（70 名男性，平均 46.7 岁；69 名女性，平均 47.3 岁）接受了站立位的直立 CT 和仰卧位的常规 CT。测量从膀胱颈到耻骨尾骨线（PCL）和肛门直肠交界处（ARJ）（定义为耻骨直肠肌后部）到 PCL 的距离。在斜轴图像上测量提肌裂孔 (LH) 的长度、宽度和面积。结果 膀胱颈（男性，22.2 +/- 4.9 mm vs 28.3 +/- 5.3 mm；女性，9.0 +/- 5.1 mm vs 19.0 +/- 4.0 mm）和 ARJ（男性，-18.8 +/- 5.5 mm vs -12.1 +/- 5.1 mm；女性，-20.0 +/- 4.7 mm vs -11.2 +/- 4.3 毫米）在站立位置显着低于仰卧位置（所有 p < 0.0001）。站立时的 LH 面积（男性 1,990 +/- 380 mm(2) vs 1,697 +/- 329 mm(2)；女性 2,284 +/- 344 mm(2) vs 1,811 +/- 261 mm(2)）明显更大（均 p < 0.0001）。女性站立位和仰卧位之间所有参数的差异均大于男性。女性的 ARJ 仅在站立位时表现出随年龄下降的显着趋势（r = -0.29，p = 0.017）。结论 站立位时膀胱颈、ARJ下降，LH区增大。女性盆底活动度比男性更大。站立时 ARJ 的下降与女性的衰老有关。
Introduction and hypothesis This study was aimed at comparing pelvic floor parameters between the standing and supine positions using upright computed tomography (CT) and evaluating the effects of sex and age in normal healthy volunteers. Methods In total, 139 volunteers (70 men, mean 46.7 years; 69 women, mean 47.3 years) underwent both upright CT in the standing position and conventional CT in the supine position. The distances from the bladder neck to the pubococcygeal line (PCL) and anorectal junction (ARJ), defined as the posterior aspect of the puborectalis muscle, to PCL were measured. The length, width, and area of the levator hiatus (LH) were measured on oblique axial images. Results The bladder neck (men, 22.2 +/- 4.9 mm vs 28.3 +/- 5.3 mm; women, 9.0 +/- 5.1 mm vs 19.0 +/- 4.0 mm) and ARJ (men, -18.8 +/- 5.5 mm vs -12.1 +/- 5.1 mm; women, -20.0 +/- 4.7 mm vs -11.2 +/- 4.3 mm) were significantly lower in the standing position than in the supine position (all p < 0.0001). The LH area (men, 1,990 +/- 380 mm(2) vs 1,697 +/- 329 mm(2); women, 2,284 +/- 344 mm(2) vs 1,811 +/- 261 mm(2)) was significantly larger in the standing position (both p < 0.0001). Differences in all parameters between the standing and supine positions were larger in women than in men. ARJ in women showed a significant tendency to descend with age only in the standing position (r = -0.29, p = 0.017). Conclusions The bladder neck and ARJ descend and the LH area enlarges in the standing position. Pelvic floor mobility is greater in women than in men. Descent of the ARJ in the standing position is associated with aging in women.