Magnetic Resonance Imaging of Normal Levator Ani Anatomy and Function
Magnetic Resonance Imaging of Normal Levator Ani Anatomy and Function
复制标题
正常提肛肌解剖和功能的磁共振成像
DOI：
10.1097/00006250-200203000-00011
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发表时间：
2002
影响因子：
7.2
通讯作者：
L. Berger
中科院分区：
文献类型：
--
作者：
Kavita Singh;W. Reid;L. Berger
目的应用动态磁共振成像技术评价正常女性肛提肌的解剖和功能。方法对12例未经绝经、无症状、无盆腔手术的绝经前妇女进行盆腔动态磁共振成像扫描。对肛提肌的来源、方位、厚度和功能进行了研究。结果回尾肌为一薄肌，呈上凸形。它向前和向内倾斜。它的厚度可变(平均厚度2.9 mm，标准偏差0.8 mm)。肌隔膜及其起始处与闭孔筋膜有明显的缝隙。耻骨直肠肌是一种较厚的肌肉。它的形状像一条包裹盆腔器官的腰带。它向后比向前高。它不附着在膀胱颈上，但输尿管和下尿路紧贴膀胱颈。耻骨直肠肌向后移动，而回尾肌向颅尾移动。结论肛提肌不是单一的肌肉，而是由厚度、来源和功能不同的两个功能成分组成。回尾肌主要起支撑作用，耻骨直肠肌具有括约肌功能。回尾肌横隔部的间隙是正常的发现。提肛肌的各个组成部分可能容易发生不同类型的分娩创伤，因此在计划康复时应分别进行评估。
OBJECTIVE To evaluate the anatomy and function of the levator ani in normal women by dynamic magnetic resonance imaging. METHODS Twelve asymptomatic, nulliparous, premenopausal women with no previous pelvic surgery underwent a dynamic magnetic resonance imaging scan of their pelvis. The origin, orientation, thickness, and function of the two components of the levator ani were studied. RESULTS The ileococcygeus is a thin muscle with an upward convexity. It slopes forward and medially. It is of variable thickness (mean thickness 2.9 mm, standard deviation 0.8 mm). There are apparent gaps in the muscle diaphragm and at its site of origin from the obturator fascia. The puborectalis is a thicker muscle. It is shaped like a belt encasing the pelvic organs. It is taller posteriorly than anteriorly. It is not attached to the bladder neck, but the midurethra and lower urethra lie in close proximity to it. The puborectalis moves dorsoventrally, whereas the ileococcygeus moves craniocaudally. CONCLUSION The levator ani is not a single muscle but has two functional components that vary in thickness, origin, and function. The ileococcygeus has a mainly supportive function, whereas the puborectalis has a sphincteric function. Gaps in the diaphragmatic portion of the ileococcygeus are a normal finding. Individual components of the levator ani may be prone to different types of childbirth trauma and should therefore be assessed separately when planning rehabilitation.