Dynamic MRI In Evaluation Of Pelvic Floor Organs And Levator Ani Muscles In Pelvic Organ Prolapse Women

Objects: Discussion on the MRI features of pelvic floor organs and levator ani muscles of pelvic floor organ prolapse(POP)patient and provide an objective basis for clinical diagnosis and treatment about pelvic floor organ prolapse.Methods:The information about 30 patients with pelvic floor organ prolapse were searched who were diagnosed as pelvic floor prolapse by clinical POP-Q in Shengjing Hospital affiliated to China Medical University from December 2016 to December 2017,and 15 healthy volunteers without pelvic floor dysfunction matched with age,BMI and birth order were selected as control group.All the subjects were scanned by dynamic and static MRI on the pelvic floor to obtain the image data.The image analysis software was used to compare the two groups of images and measure the data to observe the changes of the pelvic floor organ morphology and position.And the relative indexes of pelvic floor organ location in the state of resting and maximum force were measured,that is,the vertical distance between neck and tail line of bladder(B-PCL),Distance from cervix to pubic line(U-PCL)and Rectal protrusion depth(R-D);To observe the injury of levator ani muscle in resting state,and to use levator ani score system based on the MRI to score the levator ani muscle of all the subjects,and to divide the injury degree of levator ani muscle into three groups: no injury,mild injury and severe injury.The relative indexes of levator ani muscle were measured,including the thickness of left and right pubis rectum muscle,the thickness of iliac tailbone muscle,the area of the fissure of levator ani muscle,the angle of H line,M line and levator ani muscle plate angle at rest and maximum force.Statistical software uses SPSS 23.0,the two groups of levator ani muscle injury use chi-square test,the two groups of subjects' age,body mass index,birth order and other MRI measurements indexes use the group data t test(P < 0.05).Results:(1)B-PCL and U-PCL in POP group were lower than those in control group at rest,and the difference was statistically significant.(P<0.05)There was no statistical significance with the difference in rectal protrusion depth between the two groups(P>0.05).B-PCL and U-PCL in POP group were lower than those in control group under maximum force,and there was statistical significance with the difference.R-D in maximum exertion and the absolute values of all indexes in maximum exertion and resting state were higher than those in control group,and the difference was statistically significant.(P<0.05).(2)The degree of injury of levator ani muscle in POP group was different from that in control group,and the difference was statistically significant.(P<0.05).(3)The fissure area of levator ani muscle in POP group was larger than that in control group under resting condition.(P<0.05)The thickness of the left and right iliac caudal muscles and the right pubic rectum in the pop group were thinner than those in the control group,and the difference was statistically significant.(P <0.05)There was no statistical significance with the difference between the two groups in left pubic rectum muscle(P>0.05).(4)The H line and M line of POP group were higher than that of control group under resting condition,and the difference was statistically significant.(P<0.05)The difference about LPA was no statistical significance between the two groups.(P>0.05)LPA,H line,M line under the condition of maximum force and the difference values of all indexes in maximum force and rest are all increased obviously.(P<0.05).Conclusions: In POP patients,there were changes in the morphology and function of levator ani muscle and the pelvic floor support system was weak,resulting in the change of the location and morphology of pelvic floor organs.