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目的:探讨磁共振成像(MRI)在压力性尿失禁(SUI)诊断中的应用价值。方法:对28例有典型临床表现并经尿动力检查确诊为SUI的患者,分别在自然和应力状态下行MRI,显示不同状态下膀胱尿道的位置及形态改变,测量两种状态时膀胱尿道连接点至耻尾线的垂直距离及距离差(即下移度)。并与18例健康对照者进行比较。结果:SUI组28例应力状态下膀胱尿道连接点明显下移,其中24例下移至耻尾线以下,下移距离(10.32±1.92)mm;18例正常对照者下移距离为(5.3±1.36)mm,与SUI组比较P<0.01,且膀胱尿道连接点均位于耻尾线以上。SUI组3例可见后尿道呈漏斗状开放;对照组后尿道形态均正常。完整地显示全尿道两组总共仅15例。结论:MRI可以直接表现解剖型SUI的尿道活动及其程度,显示膀胱颈后尿道的形态,从而间接判断Ⅲ型或Ⅱ/Ⅲ混合型SUI,同时操作简便,影像清晰,直观全面,并具非侵入性,但完整地显示全尿道有待于进一步探索。
Objective: To investigate the value of magnetic resonance imaging (MRI) in the diagnosis of stress urinary incontinence (SUI). Methods: Twenty-eight patients with typical clinical manifestations who were diagnosed as SUI by urodynamic examination underwent magnetic resonance imaging (MRI) under natural and stress conditions. The bladder urethra position and morphological changes were observed under different conditions. The bladder-urethral junction To shame the vertical distance and distance difference (that is, down the degree). And compared with 18 healthy controls. Results: In the SUI group, 28 cases of bladder and urethra were significantly down-connected in stress state, of which 24 cases moved down to shame tail line, down 10.32 ± 1.92 mm; 18 cases normal controls down 5.34 ± 1.36) mm, compared with the SUI group, P <0.01, and bladder and urethral connection points are located above the sham line. The posterior urethra showed open funnel in 3 cases in SUI group, and the posterior urethra in control group was normal. Completely show the whole urethra in both groups of only 15 cases. Conclusion: MRI can directly show the urethral activity and the degree of anatomic SUI, and show the morphology of posterior urethra of bladder neck, so as to indirectly judge the type Ⅲ or Ⅱ / Ⅲ mixed SUI. At the same time, the operation is simple, the image is clear and intuitive, Invasive, but full display of the whole urethra to be further explored.