【摘要】 目的应用MRI研究中国老年男性前列腺增生患者尿道括约肌复合体的正常解剖形态。方法对68例正常控尿的中国老年男性前列腺增生患者的尿道括约肌复合体进行MRI观察,在仰卧位静息态,获取盆腔矢状面、冠状面和横截面的T2加权快速自旋回波图像。结果 68例均获得诊断质量的T2加权图像。尿道括约肌复合体由尿道平滑括约肌(中等信号)和尿道横纹括约肌(低信号)组成。自膀胱颈至精阜,尿道平滑括约肌与尿道横纹括约肌被增生的前列腺压缩成外科包膜;尿道纵行平滑括约肌止于尿道球部,尿道环形平滑括约肌向前与前纤维肌前列腺肉基质相连续形成完整的环,于膜部尿道向后止于会阴中心腱。自膀胱颈至会阴膜,尿道横纹括约肌形成戒指状的环环绕尿道,于膀胱颈处,前厚后薄,向后止于前列腺前括约肌,于膜部尿道向后止于会阴中心腱。正中矢状面图像能够测量尿道横纹括约肌长度:膜部尿道处长度为12.23~20.96 mm(平均16.56 mm);自精阜至会阴膜长度为27.85~30.68 mm(平均28.86 mm)。横断面图像能够测量膜部尿道横纹括约肌厚度,前壁肌层厚度为4.28~6.88 mm(平均5.58 mm),后壁肌层厚度2.16~2.35 mm(平均2.28 mm)。结论 MRI能够清晰显示中国老年男性前列腺增生患者尿道括约肌复合体的正常解剖形态。更多还原

【Abstract】 Objective To study the anatomy of urethral sphincter complex in elderly Chinese males with benign prostatic hyperplasia( BPH). Methods The sagittal,coronal,and axial T2-weighted non-fat suppressed fast spin-echo images of pelvic cavities of 68 Chinese elderly males with BPH were studied. Results Diagnostic T2-weighted images were obtained in all the 68 cases. The urethral sphincter complex consisted of urethral smooth sphincter( medium signal) and urethral striated sphincter( low signal). From bladder neck to verumontanum,the transition zone( TZ) and periurethral glands expanded to compress urethral sphincter complex into a surgical capsule. The longitudinal urethral smooth muscle extended down the urethra to insert at the bulbous urethra. The circular urethral smooth muscle( preprostatic sphincter) extended forward to be connected with prostatic anterior fibromuscular stroma and backward to be connected with perineal body. Between the base of the bladder and the proximal border of the prostate,the fibers of urethral striated sphincter formed a horseshoe-like arrangement,the free end of which intermingled with the smooth muscle fibers. From verumontanum to perineal membrane,urethral striated sphincter surrounded the urethra like a ring,and ended backwards in perineal body. The length of urethral striated sphincter was 12. 23-20. 96 mm( mean,16. 56 mm) at membranous urethra and 27. 85-30. 68 mm( mean,28. 86 mm) from verumontanum to perineal membrane. The thickness of striated sphincter at membranous urethra was 4. 28-6. 88 mm( mean,5. 58 mm) for the muscle of the anterior wall and 2. 16-2. 35 mm( mean,2. 28 mm) for the muscle of the posterior wall. Conclusion MRI scanning can preciously display the anatomy of urethral sphincter complex in elderly Chinese males with BPH.更多还原