经会阴盆底超声智能识别及自动测量软件量化评价膀胱后壁脱垂的初步研究

目的探讨经会阴盆底超声智能识别及自动测量软件量化评价膀胱后壁脱垂的价值。方法选择于我院超声科行盆底超声检查的130例女性膀胱脱垂患者为研究对象,分别采用超声智能识别及自动测量(以下简称智能测量)、人工测量膀胱脱垂最大距离、POP-Q分度,对比两种检测方法结果一致性。将患者根据膀胱脱垂超声分度标准分为Ⅰ、Ⅱ、Ⅲ度组,采用智能测量测定三组患者的膀胱颈距离、肛提肌裂孔面积、静息状态以及Valsalva动作的相关角度。结果智能测量与人工测量膀胱后壁脱垂POP-Q分度一致百分比为89.23%,智能测量与人工测量膀胱后壁脱垂POP-Q分度检测一致性较好(P<0.05)。智能测量与人工测量膀胱脱垂最大距离具有较好的相关性(P<0.05)。可重复性检验结果示智能测量膀胱后壁脱垂最大距离和POP-Q分度均具有较好重复性。智能测量对Ⅰ、Ⅱ、Ⅲ度组的膀胱颈距离、肛提肌裂孔面积、静息状态(膀胱尿道后角、尿道倾斜角)与Valsalva动作(膀胱颈下降值、膀胱最低点下降值、尿道旋转角、膀胱尿道膨出、孤立性膀胱膨出)分别进行比较,差异具有统计学意义(P<0.05)。结论经会阴盆底超声智能测量膀胱后壁脱垂与人工测量具有较高一致性,且具有较高重复性,测量结果稳定可靠。

Preliminary Study on Quantitative Evaluation of Posterior Wall Prolapse of the Bladder By Ultrasound Intelligent Recognition and Automatic Measurement Software

Objective To explore the value of quantitative evaluation of posterior wall prolapse of the bladder by ultrasound intelligent recognition and automatic measurement software.Methods 130 cases of female patients with bladder prolapse who underwent pelvic floor ultrasound examination in our department from were selected as subjects.Ultrasound intelligent recognition and automatic measurement(hereinafter referred to as intelligent measurement)and manual measurement of bladder were used.The maximum distance of prolapse,POP-Q index,and the consistency of the results of the two detection methods.The patients were divided intoⅠ,Ⅱ,Ⅲgroups based on ultrasonic grading criteria for bladder prolapsed.The related angel of bladder neck distance,area of hiatus of levator ANI,quiescent condition as well asValsalva action were determined and compared.Results The coincidence percentage of POP-Q index between intelligent measurement and manual measurement of posterior wall prolapse of the bladder was 89.23%(116/130).Kappa consistency test intelligent measurement and manual measurement of bladder posterior wall prolapse POP-Q index detection were in good agreement.(P<0.05).There was a good correlation between the intelligent measurement and the manual measurement of the maximum distance of bladder prolapse(P<0.05).The repeatability test results showed that the maximum distance of the posterior wall prolapse of the bladder and the POP-Q index were all reproducible.Conclusions Ultrasound measurement of the posterior wall of the bladder by the perineal pelvic floor is highly consistent with manual measurement,and has high repeatability,and the measurement results are stable and reliable.There was significant difference among the three group for the related angel of bladder neck distance,area of hiatus of levator ANI,quiescent condition(posterior vesicourethral angle,urethral inclination angle)as well asValsalva action(bladder neck drop,lowest point of bladder depression,urethral rotation angle,cystourethrocele′s olitary cystocele)(P<0.05).