动态经会阴超声与动态MRI排粪造影检查对直肠前突诊断的差异

Effects of dynamic transperineal ultrasound and dynamic magnetic resonance imaging defecography in the diagnosis of rectocele

    摘要
  • 摘要: 目的:探讨动态经会阴超声(DTPUS)与动态MRI排粪造影(DMRD)检查诊断直肠前突的一致性，比较这两种诊断方法测量直肠前突深度之间的差异性和相关性。
    方法:回顾性分析2011年9月至2012年5月南京中医药大学第三附属医院收治的18名女性直肠前突患者的临床资料。对所有患者进行DTPUS与DMRD检查，比较两种诊断方法的一致性，并观察两种方法对盆底其他异常情况的检出率。DTPUS与DMRD检查诊断直肠前突的一致性采用Cohen′s κ系数检验，DTPUS与DMRD检查测量的直肠前突深度的比较采用配对样本t检验，两者所测量的直肠前突深度的相关性采用Pearson等级相关检验。
    结果:DTPUS检查诊断的14例直肠前突的患者中，合并膀胱脱垂7例、盆底失弛缓5例、子宫脱垂2例、直肠黏膜内套叠2例、肠疝1例；DMRD检查诊断的18例直肠前突的患者中，合并膀胱脱垂12例、盆底失弛缓8例、子宫脱垂8例、直肠黏膜内套叠6例、肠疝1例。DTPUS与DMRD检查诊断直肠前突具有充分的一致性(κ=0.737，P<0.05)。DTPUS与DMRD检查测量直肠前突的深度分别为(15±6)mm(7～24 mm)和(27±7)mm(20～41 mm)，两者比较，差异有统计学意义(t=-16.124，P<0.05)。DTPUS与DMRD检查测量直肠前突深度高度相关(｜r｜=0.874，P<0.05)。随着DTPUS检查所测量的直肠前突深度的增大，DMRD检查所测量的直肠前突深度亦随之相应增大(｜r｜=1.000，P<0.05)。
    结论:DTPUS与DMRD检查诊断直肠前突的一致性高，两者所测量的直肠前突深度之间存在差异和高度相关性。DTPUS因诊断迅速，患者耐受性好而优于DMRD检查。
     

     

    Abstract: Objective:To evaluate the agreement between dynamic transperineal ultrasound (DTPUS) and dynamic magnetic resonance imaging defecography (DMRD) in the diagnosis of rectocele, and to compare the correlation and difference between the depth of rectocele measured by DTPUS and DMRD.
    Methods:The clinical data of 18 female patients with rectocele who were admitted to the Third Affiliated Hospital of Nanjing University of Chinese Medicine from September 2011 to May 2012 were retrospectively analyzed. All patients received examination via DTPUS and DMRD, and the agreement of the 2 diagnosing methods was analysed. The accurate rates of the detection of other pelvic floor abnormalities by the 2 methods were calculated. The agreement of DTPUS and DMRD in diagnosing rectocele was analysed by Cohen′s kappa test. The difference of the depth of rectocele measured by DTPUS and DMRD was compared by paired samplet test, and the correlation of the depth of rectocele measured by DTPUS and DMRD was analyzed by using the Pearson correlation coefficient.
    Results Of the 14 patients diagnosed by DTPUS, there were 7 patients with bladder prolapse, 5 with unrelaxed pelvic floor, 2 with uterine prolapse, 2 with rectal internal mucous intussusception and 1 with enterocele; of the 18 patients diagnosed by DMRD, there were 12 patients with bladder prolapse, 8 with unrelaxed pelvic floor, 8 with uterine prolapse, 6 with rectal internal mucous intussusception and 1 with enterocele. The agreement coefficient between DTPUS and DMRD in diagnosing rectocele was obvious (κ=0.737, P<0.05). The depth of the rectocele detected by DTPUS and DMRD were (15±6)mm (range, 7-24 mm) and (27±7)mm (range, 20-41 mm), with significant difference between the 2 groups (t=-16.124, P<0.05). There was a high coefficient between DTPUS and DMRD in detecting the depth of rectocele (｜r｜=0.874, P<0.05). The depth of rectocele detected by DMRD increased as the increase of depth of rectocele detected by DTPUS (｜r｜=1.000, P<0.05).
    Conclusion:The agreement between DTPUS and DMRD in diagnosing rectocele is high. The depth of rectocele measured by the 2 methods not only has statistically significance, but also exists a high degree of correlation. While DTPUS is superior to DMRD in terms of quick diagnosis and better telerance of patients.

     

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