目的 探讨与比较三维超声与三维磁共振成像在肛提肌缺损检测中的价值。方法：研究时间为2017年2月至2019年2月,选择成年健康女性志愿者64例作为对照组,选择经阴道分娩并具有盆腔脏器脱垂症状的初产妇64例作为观察组,所有入选者都进行盆底的三维超声与三维磁共振成像(MRI)检查,记录肛提肌缺损等相关参数。结果：超声显示观察组的肛提肌缺损率为34.3%,对照组为4.5%,对比差异有统计学意义(P<0.05)。观察组静息状态与盆底肌收缩状态的盆膈裂孔面积、肛门内括约肌厚度都显著高于对照组(P<0.05)。三维MRI显示观察组的肛提肌缺损率为39.1%,对照组为1.6%,对比差异都有统计学意义(P<0.05)。观察组的LHW、LHL、LPA值都显著高于对照组(P<0.05)。正常肛提肌的髂骨尾骨肌呈头尾方向走行并向上膨凸,耻骨直肠肌位置较髂骨尾骨肌低；肛提肌缺损表现为两侧不对称,阴道经缺损处向侧方膨出,病变一侧与耻骨联合分离。结论：三维超声与三维磁共振成像在盆底检测中的应用能有效反映分娩所致的肛提肌缺损,还可描述缺损肌肉与周围脏器的相互关系,具有良好的应用价值。

Objective To explore and compare the value of three-dimensional ultrasound and three-dimensional magnetic resonance imaging in the detection of levator ani muscle defects. Methods: From February 2017 to February 2019, 64 cases of healthy adult female volunteers were selected as the control group. 64 primiparas with vaginal delivery and pelvic organ prolapse were selected as the observation groups. Three-dimensional ultrasound and three-dimensional magnetic resonance imaging (MRI) examinations of the pelvic floor were performed, and related parameters such as levator ani muscle defects were recorded. Results: Ultrasound showed that the levator ani muscle defect rate were 34.3% in the observation group and 4.5% in the control group that compared the difference were statistically significant (P<0.05). The resting area of the pelvic floor and the thickness of the anal sphincter in the observation group were significantly higher than those in the control group (P<0.05). Three-dimensional MRI showed that the levator ani muscle defect rate were 39.1% in the observation group and were 1.6% in the control group, and compared the difference were statistically significant (P<0.05). The LHW, LHL and LPA values of the observation group were significantly higher than those of the control group (P<0.05). The tibialis anterior muscle of normal levator ani muscles runs in the head-to-tail direction and bulges upward. The position of the puborectalis muscle is lower than that of the tibia. The levator ani muscle defect is bilaterally asymmetrical, and the vaginal bulge is laterally bulged. The lesion side is separated from the pubic symphysis. Conclusion: The application of three-dimensional ultrasound and three-dimensional magnetic resonance imaging in pelvic floor detection can effectively reflect the levator ani muscle defect caused by childbirth, and can also describe the relationship between the defect muscle and surrounding organs, and has good application value.

R445.1

,编号：2017D01C157