Positional pelvic organ prolapse (POP) evaluation using open, weight-bearing magnetic resonance imaging (MRI)
Positional pelvic organ prolapse (POP) evaluation using open, weight-bearing magnetic resonance imaging (MRI)
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DOI：
10.5489/cuaj.2767
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发表时间：
2015-06-01
影响因子：
1.9
通讯作者：
Macnab, Andrew
中科院分区：
文献类型：
--
作者：
Friedman, Boris;Stothers, Lynn;Macnab, Andrew
前言：盆腔器官脱垂(POP)患者的磁共振成像(MRI)是在仰卧位完成的。开放式磁共振成像(MRO)使用垂直磁铁，允许以各种直立姿势进行成像。方法：11名年龄在24~65岁的女性(6名POP，5名对照)在仰卧位、坐位和站立位时连续拍摄了12幅MRO图像(骨盆中线矢状线)，同时充盈和空腹。结果：POP患者膀胱最低点至耻骨尾部(PC)和耻骨前部(PP)线之间的长度明显延长(p=0.03)，而对照组则无明显差异(p=0.07)。类似地，膀胱膨出受试者仅在站立姿势时，这一轴明显长于对照组。膀胱膨出患者仅在立位和仰卧位时，PC线下膀胱面积显著增大(p<；0.005)，且在立位时显著增大(p<；0.005)，在仰卧位时差异不显著(p=0.015)，在坐位时不显著(p=0.30)。患者坐着和站着时的影像显示，膀胱的最大下降量发生了显著的变化。
Introduction: Magnetic resonance imaging (MRI) of patients with pelvic organ prolapse (POP) is completed in the supine position. Open magnetic resonance imaging (MRO) uses vertical magnets, allowing imaging in a variety of upright postures. This pilot study used MRO to evaluate the change of prolapse in different positions compared to non-prolapsed images.Methods: In total, 11 women (6 POP, 5 controls) aged 24 to 65 years had 12 MRO images (midline sagittal pelvic line) consecutively when supine, sitting and standing with a full and empty bladder. Lengths between the lowest point of the bladder to the pubococcygeal (PC) and pubopromontoreal (PP) lines in each image were compared, and the ratio of bladder area under the PC and PP lines to the total bladder area.Results: Significant elongation between the PC line and lowest point of the bladder was evident in subjects with POP comparing supine and standing images (p = 0.03), but not controls (p = 0.07). Similarly, this axis was significantly longer in cystocele subjects versus controls only in the standing position. Bladder area under the PC line was significantly increased between supine and standing positions only among subjects with cystocele (p < 0.01), and significantly larger among the study group in the standing position (p < 0.005), less significant in the supine position (p = 0.015), and not significant in the sitting position (p = 0.3).Conclusions: MRO imaging allows us to investigate the effects of upright position and weight bearing on the staging of POP. Imaging patients when sitting and standing identified that significant changes occur in the maximal descent of the bladder.