[1]李敏,蒋涛,彭朋,等.直肠内注入模拟粪便的动态MRI对女性盆底痉挛综合征的诊断价值[J].国际放射医学核医学杂志,2016,40(3):165-170.[doi:10.3760/cma.j.issn.1673-4114.2016.03.001]
 Li Min,Jiang Tao,Peng Peng,et al.Value of dynamic MRI with rectum injection in the diagnosis of female spastic pelvic floor syndrome[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(3):165-170.[doi:10.3760/cma.j.issn.1673-4114.2016.03.001]
点击复制

直肠内注入模拟粪便的动态MRI对女性盆底痉挛综合征的诊断价值(/HTML)
分享到:

《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
40
期数:
2016年第3期
页码:
165-170
栏目:
出版日期:
2016-05-25

文章信息/Info

Title:
Value of dynamic MRI with rectum injection in the diagnosis of female spastic pelvic floor syndrome
作者:
李敏1 蒋涛1 彭朋1 梁璐1 于洋1 杨新庆2
1. 100020, 首都医科大学附属北京朝阳医院放射科;
2. 100020, 首都医科大学附属北京朝阳医院普外科
Author(s):
Li Min1 Jiang Tao1 Peng Peng1 Liang Lu1 Yu Yang1 Yang Xinqing2
1. Department of Radiology, Chao Yang Hospital, Capital University of Medical Science, Beijing 100020, China;
2. Department of General Surgery, Chao Yang Hospital, Capital University of Medical Science, Beijing 100020, China
关键词:
骨盆底磁共振成像盆底痉挛综合征
Keywords:
Pelvic floorMagnetic resonance imagingSpastic pelvic floor syndrome
DOI:
10.3760/cma.j.issn.1673-4114.2016.03.001
摘要:
目的 利用动态MRI研究直肠内模拟粪便注入前、后女性盆底痉挛综合征(SPFS)患者的肛直肠形态、功能性病变,并对多盆腔器官脱垂进行评价,明确注入球囊后的动态MRI在SPFS患者中的诊断优势。方法 对53例临床诊断为SPFS的女性患者行动态MRI检查,使用自行设计高顺应性球囊模拟大便,测量患者直肠内球囊注入前、后力排相盆底的相关数据。结果 盆底动态MRI结果显示,53例女性SPFS患者中,伴发多盆腔器官脱垂者24例。直肠内造影剂注入前、后力排相的肛直角变化,差异无统计学意义(χ2=0.603,P > 0.05);相比直肠内模拟粪便注入后的盆底动态MRI,未注入的力排相分别有18.0%(9/50)膀胱脱垂、6.1%(3/49)子宫或阴道穹窿脱垂、32.7%(17/52)直肠前膨出及14.6%(7/48)会阴体下降诊断为阴性。直肠内模拟粪便注入前、后力排相观察多盆腔器官脱垂变化,差异均有明显统计学意义。结论 直肠内注入模拟粪便的盆底动态MRI为女性SPFS患者提供了更全面的诊断,为术前正确诊断盆腔多部位缺陷及术后正确评价治疗效果提供了客观依据。
Abstract:
Objective Dynamic MRI with rectum injectionis employed to assess female spastic pelvic floor syndrome of anorectal morphology and function in relation to various pelvic compartment abnormalitiesin female outlet obstruction constipation. Methods Dynamic MRI was performed in 53 female patients(14-78 years of age, with a mean age of 52.7±15.8 years)with clinical diagnosis of spastic pelvic floor syndrome.The homemade highly conformable sacculus was inserted into the rectum to simulate stool. The relevant measurements were then obtained during straining before and after rectum injection. Results Among the 53 female patients with spastic pelvic floor syndrome, 24 patients(45.3%) have multifocal disorders involving more than one compartment.The difference in the anorectal angles before and after rectum injection was not significant(χ2=0.603,P > 0.05). Differences in the cystocele, vaginal or cervical prolapse, rectocele, and descending perineum before and after rectum injection were significant. Conclusion Using dynamic MRI with rectum injection allows for the accurate evaluation of the anorectal morphology and function related to various pelvic compartment abnormalitiesin female spastic pelvic floor syndrome; thus, this method is proved valuable in the diagnosis and treatment of female spastic pelvic floor syndrome.

参考文献/References:

[1] Times ML, Reickert CA.Functional anorectal disorders[J].Clin Colon Rectal Surg, 2005, 18(2):109-115.
[2] Drossman DA.The functional gastrointestinal disorders and the Rome Ⅲ process[J].Gastroenterology, 2006, 130(5):1377-1390.DOI:10.1053/j.gastro.2006.03.008.
[3] Maglinte DD, Kelvin FM, Fitzgerald K, et al.Association of compartment defects in pelvic floor dysfunction[J].AJR Am J Roentgenol, 1999, 172(2):439-444.DOI:10.2214/ajr.172.2.9930799.
[4] Yang A, Mostwin JL, Rosenshein NB, et al.Pelvic floor descent in women:dynamic evaluation with fast MR imaging and cinematic display[J].Radiology, 1991, 179(1):25-33.DOI:10.1148/radiology.179.1.2006286.
[5] 彭朋, 蒋涛, 杨新庆, 等.盆底动态MRI对盆底功能异常的诊断价值[J].临床放射学杂志, 2009, 28(5):711-715.Peng P, Jiang T, Yang XQ, et al.The diagnostic value of dynamic MRI in pelvic floor disfunction[J].J Clin Radiol, 2009, 28(5):711-715.
[6] Goh V, Halligan S, Kaplan G, et al.Dynamic MR imaging of the pelvic floor in asymptomatic subjects[J].AJR Am J Roentgenol, 2000, 174(3):661-666.DOI:10.2214/ajr.174.3.1740661.
[7] Fielding JR.Practical MR imaging of female pelvic floor weakness[J].Radiographics, 2002, 22(2):295-304.DOI:http://dx.doi.org/10.1148/radiographics.22.2.g02mr25295.
[8] Boyadzhyan L, Raman SS, Raz S.Role of static and dynamic MR imaging in surgical pelvic floor dysfunction[J].Radiographics, 2008, 28(4):949-967.DOI:10.1148/rg.284075139.
[9] Colaiacomo MC, Masselli G, Polettini E, et al.Dynamic MR imaging of the pelvic floor:a pictorial review[J/OL].Radiographics, 2009, 29(3):e35[2016-01-29].http://pubs.rsna.org/doi/pdf/10.1148/rg.e35.DOI:10.1148/rg.e35.
[10] 王毅, 龚水根, 张伟国.盆底MRI研究的现状[J].中华放射学杂志, 2003, 37(11):1049-1051.DOI:10.3760/j.issn:1005-1201.2003.11.018.Wang Y, Gong SG, Zhang WG.The current research of pelvic MRI[J].Chin J Radiol, 2003, 37(11):1049-1051.
[11] Reiner CS, Weishaupt D.Dynamic pelvic floor imaging:MRI techniques and imaging parameters[J].Abdom Imaging, 2013, 38(5):903-911.DOI:10.1007/s00261-012-9857-7.
[12] Maron DJ, Wexner SD.Disorders of the anorectum and pelvic floor[J].Gastroenterol Clin North Am, 2013, 42(4):XⅢ-XIV.DOI:10.1016/j.gtc.2013.10.001.
[13] Faucheron JL, Barot S, Collomb D, et al.Dynamic cystocolpoproctography is superior to functional pelvic MRI in the diagnosis of posterior pelvic floor disorders:results of a prospective study[J].Colorectal Dis, 2014, 16(7):O240-O247.DOI:10.1111/codi.12586.
[14] Kuijpers HC, Bleijenberg G.The spastic pelvic floor syndrome.A cause of constipation[J].Dis Colon Rectum, 1985, 28(9):669-672.
[15] Preston DM, Lennard-Jones JE.Anismus in chronic constipation[J].Dig Dis Sci, 1985, 30(5):413-418.
[16] Karasick S, Karasick D, Karasick SR.Functional disorders of the anus and rectum:findings on defecography[J].AJR Am J Roentgenol, 1993, 160(4):777-782.DOI:10.2214/ajr.160.4.8456664.
[17] 郭亮亮, 郭东强.直肠黏膜脱垂患者排粪造影的X线表现分级研究[J].国际放射医学核医学杂志, 2014, 38(6):381-383.DOI:10.3760/cma.j.issn.1673-4114.2014.06.008.Guo LL, Guo DQ.Defecography in patients with prolapse of rectal mucosa lesions:degrees of imaging findings[J].Int J Radiat Med Nucl Med, 2014, 38(6):381-383.
[18] Whitehead WE, Wald A, Diamant NE, et al.Functional disorders of the anus and rectum[J].Gut, 1999, 45(Suppl 2):SⅡ55-Ⅱ59.DOI:10.1136/gut.45.2008.ii55.
[19] García del Salto L, de Miguel Criado J, Aguilera del Hoyo LF, et al.MR imaging-based assessment of the female pelvic floor[J].Radiographics, 2014, 34(5):1417-1439.DOI:10.1148/rg.345140137.
[20] Jorge JM, Wexner SD, Ger GC, et al.Cinedefecography and electromyography in the diagnosis of nonrelaxing puborectalis syndrome[J].Dis Colon Rectum, 1993, 36(7):668-676.
[21] Jones PN, Lubowski DZ, Swash M, et al.Is paradoxical contraction of puborectalis muscle of functional importance?[J].Dis Colon Rectum, 1987, 30(9):667-670.
[22] 黄继兰, 蒋涛, 李敏.盆底动态磁共振成像诊断不协调性排便[J].中国医学影像技术, 2014, 30(4):556-559.Huang JL, Jiang T, Li M.Pelvic dynamic MRI in diagnosis of dyssynergic defecation[J].Chin J Med Imaging Technol, 2014, 30(4):556-559.
[23] Bolog N, Weishaupt D.Dynamic MR imaging of outlet obstruction[J].Rom J Gastroenterol, 2005, 14(3):293-302.
[24] Siegmann KC, Reisenauer C, Speck S, et al.Dynamic magnetic resonance imaging for assessment of minimally invasive pelvic floor reconstruction with polypropylene implant[J].Eur J Radiol, 2011, 80(2):182-187.
[25] Reiner CS, Tutuian R, Solopova AE, et al.MR defecography in patients with dyssynergic defecation:spectrum of imaging findings and diagnostic value[J].Br J Radiol, 2011, 84(998):136-144.DOI:10.1259/bjr/28989463.
[26] Lienemann A, Anthuber C, Baron A, et al.Dynamic MR colpocystorectography assessing pelvic-floor descent[J].Eur Radiol, 1997, 7(8):1309-1317.DOI:10.1007/s003300050294.
[27] Fletcher JG, Busse RF, Riederer SJ, et al.Magnetic resonance imaging of anatomic and dynamic defects of the pelvic floor in defecatory disorders[J].Am J Gastroenterol, 2003, 98(2):399-411.DOI:10.1111/j.1572-0241.2003.07235.x.
[28] Bertschinger KM, Hetzer FH, Roos JE, et al.Dynamic MR imaging of the pelvic floor performed with patient sitting in an open-magnet unit versus with patient supine in a closed-magnet unit[J].Radiology, 2002, 223(2):501-508.DOI:http://dx.doi.org/10.1148/radiol.2232010665.
[29] Dvorkin LS, Hetzer F, Scott SM, et al.Open-magnet MR defaecography compared with evacuation proctography in the diagnosis and management of patients with rectal intussusception[J].Colorectal Dis, 2004, 6(1):45-53.
[30] Roos JE, Weishaupt D, Wildermuth S, et al.Experience of 4 years with open MR defecography:pictorial review of anorectal anatomy and disease[J].Radiographics, 2002, 22(4):817-832.DOI:10.1148/radiographics.22.4.g02jl02817.
[31] Lamb GM, De Jode MG, Gould SW, et al.Upright dynamic MR defaecating proctography in an open configuration MR system[J].Br J Radiol, 2000, 73(866):152-155.DOI:10.1259/bjr.73.866.10884727.

相似文献/References:

[1]岳进,苏丽萍.全身MRI与PET/CT在淋巴瘤骨髓浸润诊断及预后中的作用[J].国际放射医学核医学杂志,2016,40(1):50.[doi:10.3760/cma.j.issn.1673-4114.2016.01.010]
 Yue Jin,Su Lipin.Function of whole-body MRI and PET/CT in the diagnosis and prognosis of lymphoma with bone marrow infiltration[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(3):50.[doi:10.3760/cma.j.issn.1673-4114.2016.01.010]
[2]唐令胜,刘朝晖,李红梅,等.低场磁共振DWI技术与常规MRI扫描对超急性脑梗死的诊断灵敏度的比较[J].国际放射医学核医学杂志,2016,40(3):187.[doi:10.3760/cma.j.issn.1673-4114.2016.03.006]
 Tang Lingsheng,Liu Zhaohui,Li Hongmei,et al.Comparison of the diagnostic sensitivity of low-field magnetic resonance diffusion weighted imaging technology and conventional MRI scanning for super acute cerebral infarction[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(3):187.[doi:10.3760/cma.j.issn.1673-4114.2016.03.006]
[3]贺小红,周新韩,高明勇,等.模型模拟修改部分扫描参数加速MR扫描的方法可行性探讨[J].国际放射医学核医学杂志,2016,40(4):267.[doi:10.3760/cma.j.issn.1673-4114.2016.04.006]
 He Xiaohong,Zhou Xinhan,Gao Mingyong,et al.Feasibility of accelerating MR scan by modifying part of scanning parameters:a phantom simulation study[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(3):267.[doi:10.3760/cma.j.issn.1673-4114.2016.04.006]
[4]卢瑞梁,贺小红,蔡华清,等.不同MRI序列检出聚丙烯酰胺水凝胶注射隆乳患者乳腺病变效能的比较研究[J].国际放射医学核医学杂志,2016,40(6):435.[doi:10.3760/cma.j.issn.1673-4114.2016.06.007]
 Lu Ruiliang,He Xiaohong,Cai Huaqing,et al.The different MRI sequences to detect breast lesions in polyacrylamide hydrogel injection for augmentation patients: a comparative study[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(3):435.[doi:10.3760/cma.j.issn.1673-4114.2016.06.007]
[5]廖光星,冷志欣,肖国有.前列腺癌骨转移影像诊断方法研究进展[J].国际放射医学核医学杂志,2016,40(6):464.[doi:10.3760/cma.j.issn.1673-4114.2016.06.012]
 Liao Guangxing,Leng Zhixin,Xiao Guoyou.Progress of imaging in the diagnosis of bone metastases of prostate cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(3):464.[doi:10.3760/cma.j.issn.1673-4114.2016.06.012]
[6]马彦云,张辉.磁共振体素内不相干运动扩散加权成像的原理及应用进展[J].国际放射医学核医学杂志,2016,40(6):469.[doi:10.3760/cma.j.issn.1673-4114.2016.06.013]
 Ma Yanyun,Zhang Hui.The basic principle and application progress of intravoxel incoherent motion imaging[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(3):469.[doi:10.3760/cma.j.issn.1673-4114.2016.06.013]
[7]周金鑫,张一帆.胰岛细胞移植监测的分子影像学进展[J].国际放射医学核医学杂志,2015,39(6):478.[doi:10.3760/cma.j.issn.1673-4114.2015.06.009]
 Zhou Jinxin,Zhang Yifan.Research progress of molecular imaging in monitoring islet transplantation[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(3):478.[doi:10.3760/cma.j.issn.1673-4114.2015.06.009]
[8]樊鹏,甄俊平,王峻.MR示踪技术在干细胞移植治疗软骨缺损中的研究进展[J].国际放射医学核医学杂志,2015,39(6):497.[doi:10.3760/cma.j.issn.1673-4114.2015.06.013]
 Fan Peng,Zhen Junping,Wang Jun.The progress of magnetic resonance cell tracing technique in stem cells transplantation treatment of cartilage defects[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(3):497.[doi:10.3760/cma.j.issn.1673-4114.2015.06.013]
[9]张学花,翟昭华.胰腺微囊性腺瘤影像学报道一例[J].国际放射医学核医学杂志,2015,39(6):516.[doi:10.3760/cma.j.issn.1673-4114.2015.06.019]
[10]胡鸿,唐刚华,聂大红.乳腺癌分子显像研究进展[J].国际放射医学核医学杂志,2015,39(1):91.[doi:10.3760/cma.j.issn.1673-4114.2015.01.019]
 Hu Hong,Tang Ganghua,Nie Dahong.Progress on molecular imaging of breast cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(3):91.[doi:10.3760/cma.j.issn.1673-4114.2015.01.019]

备注/Memo

备注/Memo:
收稿日期:2016-01-29
通讯作者:蒋涛,Email:jiangt8166@hotmail.com
更新日期/Last Update: 1900-01-01