Pelvic Organ Prolapse Patient’s Cervical Extension And The Degree Of Pelvic Floor Injury Of MRI Research

【Objective】Intend to assess the sensitivity and specificity of MRI diagnosis of cervicalextension, the cervical length measurement from uterus prolapse patients whoexperience the hysterectomy as the gold standard, compare with cervical lengthmeasured by MRI, follow-up so as to retain the uterus in patients with preoperativeMRI measurement of cervical length diagnostic value, understand MRI-basedmeasurement of the incidence of cervical extension in patients with pelvic organprolapse and the correlation between all apical POP-Q measures and the length of thecervix measured by MRI; Through comparing the apical pelvic organ prolapse patientswith normal cervix and cervical extension pelvis angles and the lines mark on the MRI,to evaluate pelvic injury degree of difference.【Methods】1、101cases of II°and above POP patients, which at the same time the31patientswith vaginal hysterectomy. All patients underwent pelvic organ prolapsequantification and MRI, to measure the length of the cervix and corpus. Comparedthe measurement results for patients who underwent vaginal hysterectomy withMRI, to assess the sensitivity and specificity of MRI diagnosis of cervicalextension and calculated based on measured by MRI in patients with pelvic organprolapse the incidence of cervical extension and Pearson correlation coefficientanalysis the correlation between all apical POP-Q measures and the length of thecervix measured by MRI.2、84cases of uterine Ⅱ°and above pelvic organ prolapse patients as the researchobject. All patients underwent pelvic organ prolapse quantification and magneticresonance imaging preoperative. Collecting image and measuring cervical length, patients divided into normal group and the cervical extend, and compare thedifference of H angle, G angle, H line, M line.【Results】1、Measurement the uterus after vaginal hysterectomy,24cases (77.42%) cervicalextension, while, there are25cases (80.65%) which MRI diagnosis as cervicalextension. The POP patients mean cervical length measurement by the removaluterus is5.6cm. While, MRI measurement those cervical length is5.2cm. Theuterus corpus length of patients with excision of the uterus POP patients is4.2c m.While, MRI measurement those uterus corpus is3.8cm. The data differencebetween MRI and the isolated uterine measurement was not statistically significant(P>0.05).2、MRI diagnosis cervical extension has high accuracy(AUG=0.917),the sensitivityand specificity are respectively83.3%and100%.3、In the101patients,there are59cases cervical extension and42cases of normalcervical, the incidence of pelvic organ prolapse in patients with cervical extensionis58.42%. The cervical extension group cervical length is(5.3±1.4)cm, the uteruscorpus length is(4.0±1.4)cm; pelvic organ prolapse in patients with normalcervical group cervical length is(3.0±0.6)cm, the uterus corpus length is(4.0±0.9)cm; pelvic organ prolapse patients cervical length is(4.3±1.6)cm, and itsuterus corpus length is(4.0±1.1)cm..4、Significant correlation between the length of the cervix and the location of points Cand the distance between points C and D, when examining the entire studypopulation [Pearson correlation coefficients (r) range from0.44to0.48, p valuesall <0.0001]. But not for the location of D point [Pearson correlation coefficient (r)for the0.157, P=0.117].5、G angle under resting and strain, H angle under resting, H line and M line underresting and strain there were no statistically significant difference (P>0.05), but Hangle under strain, the change from resting to strain of H angle and G angle, theposition of C point, two groups have statistical significance (P <0.05), suggesting compared with patients with cervical normal, cervical extension patients thechange of angle is relatively small.【Conclusion】1、MRI diagnosis pelvic organ prolapse in patients with cervical extension has highaccuracy;2、MRI-based measurement data shows that close to three-fifths of pelvic organprolapse in patients with cervical extension, the length of the cervix aresignificantly related to the location of points C and the distance between points Cand D, but not for the location of D point.3、MRI is an excellent tool for evaluation the real degree of injury in apical pelvicorgan prolapse (in particular is the H angle in valsalva can be more sensitive toreflect the degree of injury) to make up for the deficiencies of the existingdiagnostic methods to reduce clinical misdiagnosis of the opportunity to help thesurgeons to make correct diagnosis, provide important reference value forsurgeons for further choose the best surgical approach;4、Compared with patients with cervical extend, the pelvic floor injury of apical pelvicorgan prolapse patients with cervical normal is heavier.