The Applications Of Pelvic Anatomy Analysis By Dynamic And Static MRI Subsequence In Pelvic Reconstruction Surgeries

Objectives:Comparing the alteration of pelvic ?oor anatomy and function between the normal female and pelvic floor dysfunction ;TO probe whether pelvic floor dysfunction was associated with specific pelvic floor abnormalities; TO understand the alteration of pelvic ?oor anaomy pre and post-operative of pelvic floor dysfunction groups and evaluate the effect of pelvic floor reconstruction.Methods :Between January 2008 and march 2009, there were 32 patients who were divided into three groups according to chief symptom(POP groups 18,SUI groups 6,POP+SUI groups 8)and 14 postoperative patients,as well as 14 nulliparous control women ,who were not PFD and non pelvic surgery history.The dynamic and static values of the areas of iliococcygeus,pubococcygeus and puborectalis ,the widths of levator hiatus ,the urethrovesical angle,the lengths of H-line and M-line,the levator angle were gained by Scanning pelvic floor with 1.5T MRI of Radiology Department in the southwest hospital between PFD groups and the control groups.Comparing the alteration of pelvic ?oor anatomy between PFD and normal female; Comparing the parameters above in the pre and postoperative patients.Results:1. The static areas of iliococcygeus,pubococcygeus and puborectalis were larger than the dynamic ones(P<0.05), the dynamic widths of levator were larger than the static ones in PFD groups(P<0.05).2. There were not significant diference of the dynamic and static areas of iliococcygeus, pubococcygeus and puborectalis,the widths of levator hiatus in control groups(P>0.05).3. Comparing with the control groups, the areas of iliococcygeus,pubococcygeus and puborectalis, the widths of levator hiatus,the levator angle in PFD were smaller than the control groups(P<0.05), the urethrovesical angle,the lengths of H-line and M-line were larger than the control groups(P<0.05).4. Comparing with the control groups,there were not significant diference of the urethrovesical angle,the dynamic widths of levator hiatus and the levator angle in the postoperative patients(P>0.05),but the areas of iliococcygeus,pubococcygeus and puborectalis were smaller than the control groups(P<0.05)。5. Comparing with the preoperative patients, the urethrovesical angle,the dynamic widths of levator hiatus at in the postoperative groups were smaller than the preoperative patients(P<0.05), the average value of the lengths of H-line and M-line,the levator angle were smaller than the preoperative patients,but there are not significant diference(P>0.05)。There were not significant diference of the areas of iliococcygeus,pubococcygeus and puborectalis in the pre and postoperative patients(P>0.05).Conclusions:1. There were not significant diference of the dynamic and static areas of levator ani muscle in the normal female,but the static areas were larger than the dynamic ones,which implied that there was close relation between the damage and dysfunction of levator ani muscle.2. The areas of levator ani muscle, the widths of levator hiatus, the levator angle in PFD were smaller than the control groups,and these were in static MRI than the dynamic ones. the urethrovesical angle, the lengths of H-line and M-line in PFD were larger than the control groups,which implied that the relaxion of pelvic structure was confirmed , the key reason of the relaxion of pelvic structure may be the damage and dysfunction of levator ani muscle.3. Comparing with the control groups ,there were not significant diference of the postoperative urethrovesical angle,the dynamic widths of levator hiatus in PFD,but there were not significant diference of the areas of levator ani muscle in the pre and postoperative patients,which suggested that the normal function position of pelvic organs can be maintained by pelvic reconstruction surgeries,and the mesh or tap seems to be an optional replacement of the function of levator ani muscle to resist the abdomen pressure4. It is the safe and effect method to make accurate diagnosis of PFD by MRI ,fall scale evaluation Of the effect of in pelvic reconstruction surgeries...