| 张利敏,杨宗利,郑学东,张艳,房世保,王荣玲.经会阴盆底超声联合剪切波弹性成像测量肛提肌诊断女性压力性尿失禁[J].中国医学影像技术,2021,37(10):1514~1519 |
| 经会阴盆底超声联合剪切波弹性成像测量肛提肌诊断女性压力性尿失禁 |
| Transperineal pelvic floor ultrasound combined with shear wave elastography measurement of levator ani muscle for diagnosing female stress incontinence |
| 投稿时间：2020-10-17 修订日期：2021-08-05 |
| DOI：10.13929/j.issn.1003-3289.2021.10.019 |
| 中文关键词: 尿失禁,压力性 肛提肌 超声检查 弹性成像技术 |
| 英文关键词:urinary incontinence, stress levator ani muscle ultrasonography elasticity imaging techniques |
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| 中文摘要: |
| 目的 观察经会阴盆底超声联合肛提肌（LAM）剪切波弹性成像（SWE）诊断女性压力性尿失禁（SI）的价值。方法 对32例SI患者（SI组）和34名已育健康女性（对照组）行经会阴盆底常规超声及SWE检查，获取静息状态及最大瓦尔萨尔瓦动作下LAM弹性模量最大值（Emax）和平均值（Emean）及其最大值的差值（△Emax）和平均值的差值（△Emean）；行Logistic回归分析，绘制受试者工作特征（ROC）曲线，观察LAM各弹性模量值诊断SI的效能。结果 SI组与对照组间月经状况、尿道漏斗形成情况、BND及LAM厚度差异均有统计学意义（P均<0.05）。SI组LAM的△Emax和△Emean均小于对照组（P均<0.05）。静息状态下，SI组与对照组LAM的Emax和Emean差异均无统计学意义（P均>0.05）；最大瓦尔萨尔瓦动作下，SI组LAM的Emax和Emean均小于对照组（P均<0.05），且SI组及对照组LAM的Emax和Emean均大于静息状态下（P均<0.05）。以21.40 kPa为截断值，△Emax诊断SI的敏感度和特异度分别为80.40%和71.90%；以18.80 kPa为截断值，△Emean的敏感度和特异度分别为85.60%和85.00%，均大于△Emax（P均<0.05）。尿道漏斗形成情况、BND和△Emean是SI的独立危险因素（P均<0.05）。结论 经会阴盆底超声联合SWE 测量LAM有助于诊断女性SI；△Emean<18.80 kPa可提示SI。 |
| 英文摘要: |
| Objective To observe the value of transperineal pelvic floor ultrasound combined with shear wave elastography (SWE) measurement of levator ani muscle (LAM) for diagnosing female stress incontinence (SI). Methods Totally 32 SI patients (SI group) and 34 healthy fertile women (control group) were enrolled and underwent transperineal pelvic floor ultrasound and SWE. The maximum value (Emax) and mean value (Emean) of elastic modulus of LAM were measured at resting state and under maximum Valsalva maneuver, and the differences of maximum value (△Emax) and mean value (△Emean) of different states were measured. Logistic regression analysis was performed, and the receiver operating characteristic (ROC) curve was drawn to observe the efficiency of LAM for diagnosing SI. Results There were significant differences of menopause, urethral funnel formation, BND and thickness of LAM between groups (all P<0.05).△Emax and △Emean of SI group were lower than those of control group (all P<0.05). There was no significant difference of Emax nor Emean between groups at resting-state (all P>0.05), while Emax and Emean of SI group were lower than those of control group under the maximum Valsalva maneuver (all P<0.05), and Emax and Emean were higher than those at resting-state (all P<0.05). Taken 21.40 kPa as the cut-off value, the sensitivity and specificity of △Emax for diagnosing SI was 80.40% and 71.90%, respectively. Taken 18.80 kPa as the cut-off value, the sensitivity and specificity of △Emean was 85.60% and 85.00%, respectively, all higher than those of △Emax (both P<0.05). Urethral funnel formation, BND and △Emean were independent risk factors of SI (all P<0.05). Conclusion Transperineal pelvic floor ultrasound combined with SWE measurement of LAM were helpful to diagnosing female SI; △Emean<18.80 kPa indicated SI. |
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