肖汀,张新玲,杨丽新,毛永江,黄泽萍,甘宜鑫.超声测量肛提肌裂孔面积在女性压力性尿失禁诊断中的应用[J].中国医学影像技术,2016,32(9):1419~1422
超声测量肛提肌裂孔面积在女性压力性尿失禁诊断中的应用
Application of ultrasound in diagnosis of female stress urinary incontinence by measuring area of levator hiatus
投稿时间:2016-04-26  修订日期:2016-07-15
DOI:10.13929/j.1003-3289.2016.09.026
中文关键词:  超声检查  肛提肌裂孔  尿失禁,压力性
英文关键词:Ultrasonography  Levator hiatus  Urinary incontinence, stress
基金项目:广东省科技计划项目(2014A020212661)、广东省医学科研基金(A2015284)。
作者单位E-mail
肖汀 中山大学附属第三医院超声科, 广东 广州 510630  
张新玲 中山大学附属第三医院超声科, 广东 广州 510630 zhxl1205@126.com 
杨丽新 中山大学附属第三医院超声科, 广东 广州 510630  
毛永江 中山大学附属第三医院超声科, 广东 广州 510630  
黄泽萍 中山大学附属第三医院超声科, 广东 广州 510630  
甘宜鑫 中山大学附属第三医院超声科, 广东 广州 510630  
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中文摘要:
      目的 探讨经会阴实时三维超声测量不同状态下肛提肌裂孔面积在女性压力性尿失禁(SUI)患者中的诊断价值。方法 选取女性SUI患者260例作为病例组,60名无症状者经临床及超声检查排除SUI和(或)盆腔器官脱垂作为对照组。对两组受检者均行经会阴实时三维超声检查,分别测量并比较其静息、缩肛及瓦氏状态时的肛提肌裂孔面积,绘制ROC曲线,评估其在SUI中的诊断效能。结果 病例组患者在静息、缩肛、瓦氏状态时肛提肌裂孔面积分别为(13.59±2.82)cm2、(10.94±2.39)cm2、(23.08±7.01)cm2;对照组分别为(11.87±2.30)cm2、(9.75±;1.84)cm2、(16.15±4.10)cm2,差异均有统计学意义(P均<0.05)。静息、缩肛以及瓦氏状态时肛提肌裂孔面积诊断SUI的临界值分别为13、11、19 cm2,其敏感度分别为49.2%、40.4%、68.8%;特异度分别为80.0%、86.7%、81.7%;曲线下面积分别为0.668、0.637、0.811(P均<0.01)。结论 肛提肌裂孔面积可用于女性SUI的诊断,其中瓦氏状态时肛提肌裂孔面积在女性SUI的诊断中具有较高价值。
英文摘要:
      Objective To investigate the value of transperineal real-time three-dimensional ultrasound in the diagnosis of female stress urinary incontinence (SUI) by measuring the area of levator hiatus in different states. Methods A total of 260 cases of females with SUI were selected as the patient group. And 60 normal subjects excluding SUI and (or) pelvic organ prolapse by clinical and ultrasounic examination were selected as the control group. Transperineal real-time three-dimensional ultrasound was performed in two groups, and the area of levator hiatus in resting, contracting and Valsalva state were measured, respectively. The area of each state were compared and ROC curve was used to assess the value in diagnosis of SUI. Results The area of levator hiatus in resting, contracting, Valsalva state were (13.59±2.82)cm2, (10.94±2.39)cm2, (23.08±7.01)cm2 in the patient group, and (11.87±2.30)cm2, (9.75±1.84)cm2, (16.15±4.10)cm2 in control group respectively, there were significant difference in each area between the two groups (all P<0.05). The cut-off value of the area of levator hiatus to diagnose SUI were 13 cm2, 11 cm2, 19 cm2 in resting, contracting and Valsalva state, respectively, the sensitivity were 49.2%, 40.4%, 68.8%, and specificity were 80.0%, 86.7%, 81.7% respectively, the area under the curve were 0.668, 0.637, 0.811 (all P<0.01). Conclusion The area of levator hiatus can be used to diagnose female SUI, in which the area of levator hiatus in Valsalva state has high diagnostic value.
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