联合静态与动态磁共振排粪造影在排便障碍性疾病中的应用

目的探讨联合静态与动态磁共振排粪造影在排便障碍性疾病中的应用。方法回顾性分析2010年12月至2012年12月共94例排便障碍性疾病患者的磁共振表现,扫描序列包括SET1WI、FSET2WI及FIESTA序列行轴位、斜冠状位及正中矢状等20个时相位的动态扫描。结果 94例静态及动态磁共振排粪造影均能良好的显示盆底的解剖结构及病变征象,其中直肠前突35例,直肠下降19例,膀胱脱垂24例,子宫颈阴道脱垂20例,直肠前壁粘膜脱垂13例,直肠内套叠10例,盆底疝6例、肠疝5例,耻骨直肠肌肥厚征9例,盆底痉挛综合征23例,直肠外脱垂5例,肛门内括约肌及提肛肌损伤2例,尿失禁伴膀胱疝1例,会阴下降51例,内脏下垂6例,骶直分离3例等多种异常,同时能直观观察肠疝、膀胱疝和盆底下降。结论联合静态与动态磁共振排粪造影,能够直观显示排便障碍性疾病患者多种器质性病变及盆底肌群的功能活动状态等综合信息,能够弥补临床和其他物理检查的不足,对手术方案的制定意义重大。

Application of Combined Static and Dynamic Magnetic Resonance Defecography in Defecation Disorders

Objective To explore the application of combined static and dynamic magnetic resonance defecography in defecation disorders. Methods The clinical data of 94cases of patients with defecation disorder who had been treated in our hospital from December 2010 to December 2012 were retrospectively analyzed. Results Combined static and dynamic magnetic resonance imaged, 40 cases of patients were rectal decline, 20 cases bladder, 19 cases cervical vaginal drop down, 27 cases rectocele, 11 cases anterior rectal mucosa prolapse, 10 cases rectal intussusception, 5 cases pelvic floor hernia, 6 cases enterocele, 7 cases puborectalis muscle hypertrophy syndrome, 5 cases Spastic Pelvic floor syndrome, 12 cases external rectal prolapse, 2 cases internal anal sphincter and levator ani muscle injury, 1 cases urinary incontinence in patients with bladder hernia, descending perineum, rectal intussusception, visceral ptosis, sacral direct separation of various abnormal, and can directly observe the enterocele, hernia of bladder and pelvic floor down. Conclusion The combination of static and dynamic magnetic resonance defecography displayed comprehensive information including defecation disorders in patients with a variety of organic disease and function of pelvic floor muscle activity, and also can make up for the lack of clinical and other physical examination, it has great significance in making operation plan.