MR排粪造影在女性出口梗阻型便秘研究中的应用价值

目的 利用MR排粪造影研究女性出口梗阻型便秘的肛、直肠形态及功能性病变,同时对前、中盆腔联合性病变进行全面评价.方法 107例临床诊断为出口梗阻型便秘的女性患者,年龄20～84岁,平均55岁,进行MR排粪造影检查,使用自行设计高顺应性球囊模拟大便,分别测量静息、提肛及力排时盆底相关数据.结果 107例出口梗阻型便秘患者中,70例直肠前膨出(65.4%),为女性出口型便秘常见梗阻因素;85例(79.4%)患者为2种及2种以上的联合性病变,并发前、中盆腔病变,包括60例膀胱脱垂(56.1%)、59例子宫或阴道穹窿脱垂(55.1%)、54例会阴体下降(50.5%)、28例盆底疝(26.2%).结论 MR排粪造影不仅能准确评价出口梗阻型便秘女性患者的肛、直肠形态及功能性病变,同时能对前、中盆腔联合性病变进行全面评价.

Female outlet obstruction constipation: assessment with MR defecography

Objective Using MR defecography to assess the morphological and functional anorectal anomalies related to female outlet obstruction constipation, and evaluate the joint disease of anterior and mid pelvic. Methods One hundred and seven female patients, aged 20 to 84 years ( average, 55 years), were diagnosed as outlet obstruction constipation based on clinical symptoms and signs. They all received MR defecography in our institution. The high compliance homemade balloon was inserted into rectum to simulate stool Then relevant measurements were obtained during rest, squeezing and straining, respectively. Results In all the 107 cases, 70 ( 65.4% ) presented rectocele on dynamic MRI; 28 ( 26. 2% ) presented anismus;60 (56. 1% ) presented cystocele; 59 presented vaginal or cervical prolapse(55. 1% ); and, 54 (50. 5% )presented descending perineum. In 85 females (79.4%) multiple disorders were detected, involving more than one pelvic compartment. Conclusion MR defecography allowed to accurately evaluate the morphological and functional anorectal anomalies related to female outlet obstruction constipation, and the joint disease of anterior and mid pelvic.