盆底三维Hyaline成像技术观察女性阴道旁支持结构的初步探讨

摘要

目的 应用三维Hyaline成像技术观察正常女性盆底阴道旁支持结构,探讨其特征性表现和临床应用可行性.方法 选取正常未育女性54例,在静息状态下获取经会阴三维超声容积数据,离线后处理获取三维Hyaline图像,在阴道第Ⅱ水平轴平面上观察阴道旁结构的形态特征,分别测量双侧阴道旁结构距尿道中心的前后及左右距离.并通过计算组内相关系数评估不同观察者间测量结果的一致性.结果 在三维Hyaline成像上,阴道第Ⅱ水平轴平面上阴道旁支持结构呈典型的穹顶状,阴道旁结构距尿道中心的前后距离:左侧(-0.31 ±1.29)mm、.右侧(0.47 ±0.99) mm,左右距离:左侧(12.67 ±6.70)mm、右侧(13.01±5.75) mm.双侧阴道旁支持结构距尿道中心的前后及左右距离比较差异均无统计学意义(P＞0.05).不同观察者在辨认阴道第Ⅱ水平阴道旁支持结构形态及测量阴道旁结构距尿道中心距离上具有很高的一致性,组内相关系数为0.87和0.82.结论 盆底三维Hyaline成像技术可以观察女性阴道旁支持结构,正常阴道旁支持结构呈典型的“穹顶”状,并与尿道中心位于同一水平、左右对称.为今后研究妊娠分娩与阴道旁支持结构损伤相关性提供了正常解剖结构的影像学依据.%Objective We aim to evaluate and discuss the feasibility of Hyaline imaging of three-dimension sonography in observation of paravaginal support structure in normal nonporous women.Methods Total of 45 normal infertile women were chosen.Three-dimensional volume datasets were collected at rest by transperineal ultrasound.The three-dimensional Hyaline images were acquired off-line.We observed the morphologic features of paravaginal support structure on the axial plane in middle vagina and measured the anteroposterior and lateral horizontal distances between bilateral paravaginal support structure and ureter.The consistency between two sonographers were analyzed by intraclass correlation coefficient (ICC).Results In three-dimensional Hyaline imaging sonogram,paravaginal support structure was appeared as typically tenting-like shaped.The anteroposterior distances between paravaginal support structure and center of ureter were listed as followed:left (-0.31 ± 1.29) mm,right (0.47 ± O.99) mm.While the lateral horizontal distances were left (12.67 ± 6.70) mm,right (13.01 ± 5.75) mm.There were no statistical differences between bilateral both anteroposterior and lateral horizontal distances.The consistency between two sonographers for distinguishing paravaginal support structure on the middle-vaginal plane and measuring distances between paravaginal support structure and center of ureter was remarkably high (ICC is 0.87 and 0.82).Conclusions Hyaline imaging technology of three-dimensional pelvic floor sonography could be used to observe paravaginal support structure in women.The normal paravaginal support structure is typically showed as bilateral symmetrical tenting-like structure,which is on the same level as the center of ureter.It provides normal anatomic radiological evidence and helps study defect of paravaginal support structure caused by pregnancy or delivery.