超声评价女性压力性尿失禁患者盆膈裂孔形态

目的 探讨经会阴三维盆底图像重建技术评估女性压力性尿失禁患者不同状态下盆膈裂孔及肛提肌形态变化的价值。方法 收集压力性尿失禁((SUI)患者40例(病例组)及同期妇科良性疾病患者各40例(对照组),对所有患者均于静息、瓦氏、缩肛状态下在盆膈裂孔最小平面上,进行经会阴三维超声容积扫查,重建盆底图像并观测盆膈裂孔(LH)前后径(LH-M)、左右径(LH-N)、面积(LH-S)、周长(LH-L)、肛提肌厚度(T),对两组间的差异进行统计学分析。结果 静息、瓦氏、缩肛状态下病例组LH-M、LH-S、LH-L较对照组增大,LH-M、LH-S差异具有统计学意义(P均<0.05),LH-N差异无统计学意义(P均>0.05);缩肛状态下LH-L差异无统计学意义(P>0.05),静息及瓦氏状态下,LH-L差异具有统计学意义(P<0.05);静息状态下肛提肌厚度差异无统计学意义(P>0.05),而瓦氏状态下和缩肛状态下右侧肛提肌厚度差异有统计学意义(P均<0.05)。结论 三维盆底图像重建技术可用于观测女性压力性尿失禁患者盆膈裂孔及肛提肌形态。

Ultrasound on evaluation of levator hiatus situation in female patients with stress urinary incontinence

Objective To explore the value of pelvic floor image reconstruction technology with translabial and three-dimensional ultrasound on evaluation of the situation of levator hiatus and levator ani in female patients with stress urinary incontinence (SUI). Methods Fourty patients who were clinical diagnosised as SUI (case gruop) and at the same time of fourty patients with benign disease of gynaecology (control group) were enrolled. All subjects were checked in three states (resting, Valsalva, levator ani muscle maximum contraction state) in the levator hiatus minimum plane with translabial and three-dimensional ultrasound. The volume date and the image reconstruction of the pelvic floor were obtained to measure anteroposterior diameter of levator hiatus (LH-M), transverse diameter of levator hiatus (LH-N), area of levator hiatus (LH-S), perimeter of levator hiatus (LH-L) and the thickness of levator ani muscle (T), and the difference between two groups were analyzed statistically. Results Under resting, Valsalva, levator ani muscle maximum contraction state, LH-M, LH-S, LH-L of levator hiatus in case group were larger than those in control group. There were significantly differences of LH-M and LH-S between the two groups (all P<0.05), while there was no difference of LH-N (all P>0.05). At levator ani muscle maximum contraction state, there was no difference of LH-L (P>0.05), while there were significantly different at rest and Valsalva state (all P<0.05). At rest, there was no difference of levator ani T between the two groups (both P>0.05), while the differences of right levator ani T were statistically significant between the two groups at Valsalva and levator ani muscle maximum contraction state (both P<0.05). Conclusion Three-dimensional image reconstruction of pelvic floor technique can be used for evaluation of the situation of levator hiatus and levator ani in female patients with SUI.