| Background As one of the most common malignant tumors in women,cervical cancer seriously threatens women's life and health.In recent years,the incidence of cervical cancer has been rising and the incidence of cervical cancer is younger.[1]Extensive hysterectomy combined with bilateral pelvic lymphadenectomy is the most basic method for the treatment of early cervical cancer.Pelvic floor neuromuscular injury caused by extensive hysterectomy has been widely recognized as one of the pathogenesis of pelvic floor dysfunction in women after operation.Postoperative pelvic floor dysfunction occurred to varying degrees,including bladder dysfunction,anorectal dysfunction and sexual dysfunction.However,few studies have reported the incidence of pelvic floor dysfunction in patients with cervical cancer.If patients may have different degrees of pelvic floor dysfunction such as urinary incontinence,pelvic organ prolapse and sexual dysfunction,radical operation of cervical cancer will inevitably aggravate the symptoms of pelvic floor dysfunction.The advantages of pelvic floor dynamic MRI,such as non-radiation,high resolution and strong contrast of soft tissue,can provide objective imaging data for the diagnosis of pelvic floor dysfunction diseases and the understanding of the severity of pelvic floor functional changes.In this study,static and dynamic magnetic resonance pelvic floor scanning was used to evaluate the pelvic floor structure and function of patients with cervical cancer.Objective The pelvic floor dynamic MRI technique was applied to comprehensively evaluate the position,movement and anatomical structure of pelvic floor organs of cervical cancer patients before and after surgery,combined with the measurement reference indexes of different imaging sequences.It provides theoretical basis for further improving postoperative quality of life and reducing postoperative complicationsMethod Thirty patients with cervical cancer of stage 1A2-IIB in our hospital from January2017 to June 2018 were selected.The average age of the patients was 47.11±8.29 years old,the average number of births was 1.95±0.75,and the body mass index?BMI?was26.17±0.8 kg/m2.Among them,there were 11 cases of IA1 stage,8 cases of IA2 stage,7cases of 1B1 stage,22 cases of IB2 stage and 2 cases of IIB stage.The pelvic floor function and symptoms of cervical cancer patients were comprehensively evaluated by pelvic floor dynamic magnetic resonance scanning.The image analysis software was used to compare the imaging data and measure the data.The changes of pelvic floor organ morphology and location were observed in patients with cervical cancer.The relative indexes of pelvic floor organs were measured in resting period and maximum exertion state of patients with cervical cancer.The distances from pelvic organs to PCL line and MPL line were measured respectively,and the changes of pelvic organs in patients with cervical cancer were evaluated.The degree of pelvic organ prolapse in cervical cancer patients was evaluated by PCL and MPL measurements.The parameters of levator ani muscle in patients with cervical cancer were measured,including the static and dynamic area of iliococcygeal muscle,pubococcygeal muscle and rectus pubis muscle,the static and dynamic width of levator ani muscle hiatus,H line,M line and the angle of levator ani muscle plate.The data were input into SPSS 20.0 software for statistical analysis.The measured data conforming to normal distribution were described by means of mean±standard deviation???.T-test was used for data comparison.Group data t test showed that P<0.05 showed significant difference.Result 1.Two dynamic pelvic floor MRI methods:PCL line and MPL line were used to measure the pelvic organ motility in patients with cervical cancer.The difference of the pelvic floor organ descending position between the two reference lines during the maximum exertion period and the rest period was statistically significant?P<0.05?.the MPL line showed a statistically significant difference in the incidence of anterior,middle and posterior ventricular prolapse compared with the PCL line,?P<0.05?.2.The measurements of anal and rectal connection and bladder neck during the rest period and maximum exertion period after cervical cancer surgery were significantly lower than those before surgery,?P<0.05?.The values of rectoanal junction and bladder neck in the period of postoperative rest and maximum exertion were higher than those before surgery,?P<0.05?.3.Indicators of pelvic floor support structure in patients with cervical cancer:morphological indexes of the levator ani muscle after surgery,the area of the iliococcygeus,the area of the coccygeus,the area of the rectus pubis during the rest period and the maximum force period were significantly lower than those before surgery,P<0.05.Indexes of levator ani muscle support ability:the levator plate Angle,iliac crest and coccyx Angle,h-line and m-line during the rest period and maximum force period after the operation were significantly higher than those before the operation,P<0.05.Conclusion 1.Pelvic floor dynamic MRI showed that there were different degrees of changes in pelvic floor organ location and morphology before and after operation in patients with cervical cancer,as well as the decrease of pelvic floor support structure and ability.2.Dynamic pelvic floor MRI can evaluate pelvic floor anatomy and morphology,and provide anatomical basis for reducing postoperative complications and improving the quality of life of patients. |
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