经会阴二维超声联合剪切波弹性成像诊断经阴道 分娩后压力性尿失禁的临床价值

打开文本图片集

Clinical value of transperineal two-dimensional ultrasound combined with shear wave elastography in the diagnosis of stress urinary incontinence after vaginal delivery

ABSTRACTObjectiveTo explore theclinical valueof transperineal two-dimensional ultrasoundcombined with shear waveelastography（SWE）inthe diagnosisofpostpartumstress urinaryincontinence（SUI） in womenaftervaginaldelivery. MethodsAtotal of 7O postpartum women who developed SUI at 8 weeksafter ful-term singletonvaginal delivery were enrolld as the SUI group，andanother7O womenwithout SUIselectedasthecontrol group.Transperineal two-dimensional ultrasoundwasused to measurethethickness of theanteriorand posteriorlipsofthebladderneck，bladderneck displacement （BND），and urethralrotation angle（URA）.SWE was usedto measure theaverage Young’smodulus（Emean）ofthe anteriorand posterior bladderneck lips，thedifferences in theseparametersbetween thetwogroups wereanalyzed.Logisticregression analysiswasperformedtoscren theindependentinfluencing factorsofpostpartum SUIinwomenaftervaginaldelivery.The diagnostic eficacyof each parameter aloneand incombinationwas evaluatedbyreceiveroperating characteristic（ROC）curve analysis.ResultsThethicknessof theanteriorand posteriorbladderneck lips，BND，andURAintheSUgroupwerehigher thanthose inthecontrol group，whiletheEmeanoftheanteriorand posterior bladder neck lips werelowerthan thosein the control group，the differences were statistically significant（all P <0.001）.Logistic regression analysis showed that the thickness of theanteriorandposteriorbladderneck lips，BND，URA，andEmeanof theanteriorandposterior bladdernecklipswere independent influencing factors for diagnosing postpartum SUI in women after vaginal delivery（all P <0.05）.ROC curve analysis showed hattheareaunder thecurve（AUC）ofthethicknessoftheanteriorandposteriorbladdernecklips，BND，URA，and Emeanoftheanteriorand posteriorbladderneck lipsfordiagnosing postpartum SUin womenaftervaginaldeliverywere0.774， 0.766，0.737，0.726，0.850，and0.827，respectively.Thecombinedaplicationofthese parametersyieldedanAUCof0.907， which was significantly higher than that of each parameter alone（all P<0.05 ）.ConclusionTransperineal two-dimensional ultrasound combined withSWE has good clinical value in diagnosing postpartumSUIin women after vaginal delivery.

KEYWORDsUltrasonography，two-dimensional，transperineal;Shear waveelastography；Vaginaldelivery；Stress urinary incontinence;Bladder neck

在女性控尿系统中，由环状平滑肌围绕膀胱颈组成的尿道内括约肌是控制尿道关闭的重要部分，与尿道外括约肌共同决定控尿机制的完整性[1]。（剩余7448字）