磁共振成像在压力性尿失禁诊断中的应用价值

目的:探讨磁共振成像(MRI)在压力性尿失禁(SUI)诊断中的应用价值。方法:对28例有典型临床表现并经尿动力检查确诊为SUI的患者,分别在自然和应力状态下行MRI,显示不同状态下膀胱尿道的位置及形态改变,测量两种状态时膀胱尿道连接点至耻尾线的垂直距离及距离差(即下移度)。并与18例健康对照者进行比较。结果:SUI组28例应力状态下膀胱尿道连接点明显下移,其中24例下移至耻尾线以下,下移距离(10.32±1.92)mm;18例正常对照者下移距离为(5.3±1.36)mm,与SUI组比较P<0.01,且膀胱尿道连接点均位于耻尾线以上。SUI组3例可见后尿道呈漏斗状开放;对照组后尿道形态均正常。完整地显示全尿道两组总共仅15例。结论:MRI可以直接表现解剖型SUI的尿道活动及其程度,显示膀胱颈后尿道的形态,从而间接判断Ⅲ型或Ⅱ/Ⅲ混合型SUI,同时操作简便,影像清晰,直观全面,并具非侵入性,但完整地显示全尿道有待于进一步探索。

Rudiment ques of diadynamic value of MRI in female stress urinary incontinence

Objective:To discuss diagnosis value of MRI in female stress urinary incontinence(SUI).Methods:The static and dynamic distance between the pubococcygeal line and urethra-vesical joint were measured both in 28 patients with symptom of SUI diagnosed by urinary dynamics and 18 healthy controls at MRI picture and compared.Results:Urethra-vesical joints descended in all 28 cases of study group ,descented infra pubococcygeal line in 24 cases of the total. The distance of descenting was ((10.32)(1.92))mm in study group. The distance of descenting was((5.3)(1.36))mm and Urethra-vesical joints above pubococcygeal line in control group. There was higher significant difference between study group and control group(P<(0.001)). Urethra was full displayed in 15 cases of all . Posterior urethra opened funnel-shaped in 3 cases of study group and was normal in all cases of control group.Conclusions:MRI is a convenient,non-invasion diagnostic device and able to display clear picture. MRI can direct display urethra movement and its degree in dissection-SUI, can indirect definite type or / mixed type of SUI by display the form of bladder neck and urethra. But it still need research how urethra can be full displayed.