【摘要】 目的通过磁共振成像(MRI)扫描评估盆腔器官脱垂(pelvic organ prolapse,POP)患者骶韧带的形态学特征,并探讨其临床意义。方法对26例POP患者和4例非POP志愿者进行POP-Q分期及盆腔MRI检查,在静息相以T2加权快速恢复快速自旋回波序列(T2 weighted Fast Recovery FSE)进行轴位扫描,分别测量并比较上述两组骶韧带位置、厚度和骶韧带信号强度的差异以及不同脱垂部位、程度患者骶韧带的差异。结果与非POP组比较,26例POP患者的骶韧带在MRI轴位图像中可辨识的最下方位置为坐骨棘下方(-6.00±8.42)mm,双侧骶韧带止点至骶尾骨中线的距离分别为(57.95±10.75)mm、(48.10±9.37)mm,差异均有统计学意义(P=0.002,P=0);左、右侧骶韧带厚度分别为(29.80±10.05)mm、(30.60±9.50)mm,差异无统计学意义(P左=0.499,P右=0.212)。其中25例POP患者骶韧带止点(96.2%)位于骶棘韧带/尾骨肌复合体上。POP患者中仅阴道前壁脱垂程度与年龄(β=0.432)及双侧骶韧带信号强度(β左=0.405,β右=0.456)相关。结论 POP患者子宫骶韧带起止点存在变异,右侧长于左侧,其整体下移而在矢状位上延伸距离、厚度未改变;MRI中骶韧带区域信号强度可能成为评估AWP患者骶韧带损伤程度的新方法。更多还原

【Abstract】 Objective To identify and describe the uterosacral ligaments on magnetic resonance imaging (MRI) scans, and explore the features of the patients with POP.Methods Twenty six women with POP diagnosed by POP-Q system and four asymptomatic women volunteered were admitted. T2 FSE pelvic MRI axial plane scans were obtained in resting phrase. Relevant measurements were performed and compared by different POP stages and positions.Results Uterosacral ligaments were visible in all the analyzable scans,96.2%(25/26) ligments insert on the sacrospinous ligament/coccygeus muscle complex. In its craniocaudal extent,left uterosacral ligament was shorter. Measurements for cases and controls were as follows: The first uterosacral-ligament-identifiable image above the ischial spine was (-6.00±8.42)mm vs(8.75±4.79) mm,(P=0.002),the distance between the first and last image bilateral was (29.80±10.05 vs 26.25±4.79) mm,(P=0.499),(30.605±4.7) vs (27.50±2.89) mm,(P=0.212). The degree of AWP was moderate positively correlated to age(β=0.432),signal intensity (SI) of uterosacral ligaments on the left side was obviously higher. Conclusions The original and insert points of uterosacral ligments in patients with POP present certain degree anatomical variation, length on left side are shorter in the craniocaudal extent. Compared to controls,uterosacral ligments of POP patients move downward with invariant thickness. SI may become a promising method to evaluate the impaired degree of the uterosacral ligaments with AWP.更多还原