目的 探讨盆底肌群的解剖及功能改变与尿失禁( stress urinary incontinence,SUI组)的相关性. 方法收集2005年初至2006年初收住入院的病例43例,年龄40~82岁 ,SUI组20例,对照组23例.所有病例均行MRI扫描,扫描范围是横断位上缘至髂嵴水平、下缘扫描至肛门口,矢状位向两侧扫描至髋臼外侧缘.完成平静扫描后,嘱患者进行缩肛并坚持,重复FSE序列矢状位、横断位T2WI扫描.利用医学影像分析系统软件分析处理MRI原始图像.结果 运用方差分析,分别对平静、缩肛状态下及缩肛前后组间的左右两侧肛提肌厚度进行组间比较,差异无显著性,在平静及缩肛状态下,将两组人群的左右肛提肌厚度进行自体比较,对照组和尿失禁组均有显著性差异,对缩肛前后同侧肛提肌厚度进行比较,对照组两侧肛提肌厚度均有显著性差异,尿失禁组两侧肛提肌厚度均无差异. 结论肛提肌存在不对称现象,尿失禁患者肛提肌的收缩功能可能下降.
Objective To study the correlation of morphological and functional changes of the levator animucle muscle and stress urinary incontinence(SUI) ; to get MRI diagnostic criteria of SUI and to give a possible explanation for SUI mechanisms. Methods Between March 2005 and March 2006, 20 female in-patients were referred to our SUI study according to SUI diagnostic criteria. They ranged from 40 to 82 years of age. Twenty three female in-patients without SUI were referred to our study as normal control at the same period. All patients underwent MRI scan. Statiic and straining MRI images consisted of sagittal and axial T2 -weighted FSE sequences. Transection scan range from the iliac crest to anus, sagittal scan between bi-acetabula. All images were taken by the same equipment and reported by the same doctor-group. Results Analysis of variance was used to analyze differences in thickness of levator ani muscle, angle between levator ani and plat line, volume of levator ani among sidentong static, straining, pre- and after straining of two groups. Comparisons of two groups' anteroposterior diameter (A-P) and left to right diameter (L-F) of levator ani gap showed no significantly difference. Both in control group and SUI group, there were significant differences between the right and left levator thickness. There was statistical significance between the same levator ani thickness under the pelvic strained and relax station in control group, but no significant difference in SUI group. Conclusion Levator ani' s incontinence, that is "gap", is on an increasing trend as symptom. There is asymmetry between the left and right levator ani nuscle in normal females. The contractive function of the levator ani miscle is decreased in SUI patients.