动态MRI评价女性盆腔器官脱垂的初步研究

目的评价动态MRI的检查技术对女性盆腔器官脱垂的诊断价值。方法对24例临床诊断为盆腔器官脱垂的患者行正中矢状位的动态MRI检查,在患者行Valsalva动作时应用单次激发的快速自旋回波序列成像,按HMO分度系统做出MRI诊断及测量,其中22例患者在行盆底修复手术后又进行了同样检查,因此对共计46例盆腔动态MRI检查测量结果与临床诊断结果进行对比统计学分析。结果在46例盆底动态MRI中,43例MRI诊断与临床诊断一致,经Kappa检验,κ=0.862。动态盆腔MRI检查与临床测量对盆底前部、顶部器官脱垂的测量值相关性较好（Spearman相关系数r分别为0.650,0.520）;对盆底后部器官脱垂的测量值相关性较差（r=0.290）。结论动态盆腔MRI可以全面评价盆腔脏器的脱垂情况,可作为临床有效的盆底功能评价的方法 。

Preliminary study of dynamic MR imaging in evaluation of female pelvic organ prolapse

Objective：To assess the clinical value of dynamic MRI in diagnosis of female pelvic organ prolapse （POP）. Materials and Methods：Twenty-four patients with clinically diagnosed POP underwent dynamic mid-sagittal plane pelvic MRI using single-shot fast spin-echo （SSFSE） sequence during Valsalva maneuver. MRI diagnosis and measurement were made according to HMO classification system. Of them,twenty-two patients were obtained the same MRI and clinical evaluation again after the pelvic-floor-repair surgery. Therefore,all together 46 MRI examinations were compared with the clinical evaluation statistically. Results：In 46 dynamic pelvic MRI exams,43 MRI exams had good consistency with the clinical evaluation analyzed by Kappa test （κ=0.862）. Dynamic MRI measurements had good correlation with clinical measurements in the anterior and apical compartments estimated by Spearman rank （r=0.650,r=0.520,respectively）,and poor correlation with clinical measurements in the posterior compartment （r=0.290）. Conclusion：Dynamic MRI examination may evaluate the pelvic organ prolapse comprehensively. It＇s an effective method to assess the pelvic floor dysfunction clinically.