围下降测量在盆床成像的评估
Isabelle M A van Gruting1, Kirsten Kluivers2, Aleksandra Stankiewicz3,4
1Department of Obstetrics and Gynaecology, Croydon University Hospital, Croydon CR7 7YE, UK.
Journal of clinical medicine
|January 25, 2025
概括
本研究验证了一种使用各种成像技术测量围下降的方法,确定切断值并评估诊断准确性. 周围下降与骨盆器官脱落和便秘症状相关,而不是典型的受阻排便症状.
科学领域:
- 盆地图像和诊断 盆地图像和诊断
- 胃肠病学和结直肠外科手术
- 妇女健康和骨盆底功能障碍
背景情况:
- 周围下降测量缺乏标准化在不同的成像方式.
- 了解围下降在阻塞性排便综合征 (ODS) 的临床相关性至关重要.
- 诊断测试准确性 (DTA) 的成像技术的周围下降需要评估.
研究的目的:
- 通过多种成像技术验证一种统一的方法来测量周围下降.
- 确定围下降测量的切线值,并评估DTA.
- 在患有ODS的女性中,与症状,征兆和成像发现相关联周围下降.
主要方法:
- 对131名患有ODS症状的女性进行横截面研究.
- 使用了疏散截图 (EP),MRI,跨膜超声波 (TPUS) 和内阴道超声波 (EVUS).
- 测量静态和动态周围下降;DTA估计使用隐性类分析.
主要成果:
- 用MRI和EVUS进行动态周围下降的观察者间一致性很好;用EP和TPUS中等.
- 建立了新的截止值:EP 20毫米,MRI 35毫米,TPUS 15毫米,EVUS 15毫米.
- 静态下降与骨盆器官脱落 (POP) 和上升器和肌肉脱落相关;动态下降与紧张和药使用相关. 典型的ODS症状没有相关性.
结论:
- 动态围下降是一种可靠的,跨成像技术标准化的测量方法.
- 静态下降与POP有关,而动态下降与便秘有关.
- 超声波 (TPUS,EVUS) 提供与EP和MRI相比的特异性,用于初始的骨盆地功能障碍评估.
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