Five-year outcome after pelvic floor reconstructive surgery: evaluation using dynamic magnetic resonance imaging compared to clinical examination and quality-of-life questionnaire

Céline D Alt; Laura Benner; Theresa Mokry; Florian Lenz; Peter Hallscheidt; Christof Sohn; Hans-Ulrich Kauczor; Kerstin A Brocker

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Five-year outcome after pelvic floor reconstructive surgery: evaluation using dynamic magnetic resonance imaging compared to clinical examination and quality-of-life questionnaire

机译：骨盆楼层重建手术后的五年结果：使用动态磁共振成像进行评估与临床检查和生活质量问卷相比

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Background Dynamic magnetic resonance imaging (dMRI) captures the entire pelvis during Valsalva maneuver and helps diagnosing pelvic floor changes after reconstructive surgery. Purpose To evaluate therapeutic outcome five years after reconstructive surgery using clinical examination, dMRI, and quality-of-life (QOL) questionnaire. Material and Methods Clinical examination, dMRI, and QOL questionnaire were conducted before surgery and in the follow-ups at 12 weeks, one year, and five years in women with pelvic organ prolapse (POP) stage ≥2. dMRI was performed at 1.5-T using a predefined protocol including sagittal T2-weighted (T2W) sequence at rest and sagittal T2W true-FISP sequence at maximum strain for metric POP measurements (reference points?=?bladder, cervix, pouch, rectum). Pelvic organ mobility (POM) was defined as the difference of the metric measurement at maximum strain and at rest. Results Twenty-six women with 104 MRI examinations were available for analysis. dMRI results mostly differ to clinical examination regarding the overall five-year outcome and the posterior compartment in particular. dMRI diagnosed substantially more patients with recurrent or de novo POP in the posterior compartment (n?=?17) compared to clinical examination (n?=?4). POM after five years aligns to preoperative status except for the bladder. POM reflects best the QOL results regarding defecation disorders. Conclusion A tendency for recurrent and de novo POP was seen in all diagnostic modalities applied. dMRI objectively visualizes the interaction of the pelvic organs and the pelvic floor after reconstructive surgery and POM correlated best with the women’s personal impression on pelvic floor complaints.

机译：背景技术动态磁共振成像（DMRI）在Valsalva机动期间捕获整个骨盆，并帮助诊断重建手术后的骨盆底部变化。目的在使用临床检查，DMRI和寿命质量（QOL）问卷后，在重建手术后五年评估治疗结果。材料和方法临床检查，DMRI和QOL问卷在手术前进行，并在12周，一年和五年的患有盆腔器官脱垂（POP）阶段≥2的妇女的后续患者进行。 DMRI在1.5-T以1.5-T进行，使用预定的协议在休息和矢状T2W True-FISP序列处以最大应变为度量的测量，用于度量流出测量（参考点？=？膀胱，子宫颈，小袋，直肠）。盆腔器官移动（POM）被定义为最大应变下度量测量和静止的差异。结果26名患有104例MRI考试的妇女进行分析。 DMRI结果大多是关于整体五年结果和后舱的临床检查。与临床检查相比，DMRI在后舱（n≤=α17）中诊断出更多的患者复发或de novo pop（n？=Δ17）（n？= 4）。五年后的POM与膀胱除外的术前状态保持一致。 POM反映了关于排便障碍的QoL结果。结论在所有诊断模式中看到了复发性和DE NOVO流行的趋势。 DMRI客观地可视化了骨盆器官和骨盆底的相互作用后重建手术和POM与女性对骨盆地板投诉的个人印象相关。

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《Acta Radiologica》 |2018年第10期|共10页
作者
Céline D Alt; Laura Benner; Theresa Mokry; Florian Lenz; Peter Hallscheidt; Christof Sohn; Hans-Ulrich Kauczor; Kerstin A Brocker;
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作者单位

Department of Diagnostic and Interventional Radiology University of Heidelberg Medical School;

Institute of Medical Biometry and Informatics University of Heidelberg Heidelberg Germany;

Department of Diagnostic and Interventional Radiology University of Heidelberg Medical School;

Department of Obstetrics and Gynecology St. Marienkrankenhaus Ludwigshafen Academic Teaching;

Department of Diagnostic and Interventional Radiology University of Heidelberg Medical School;

Department of Obstetrics and Gynecology St. Marienkrankenhaus Ludwigshafen Academic Teaching;

Department of Diagnostic and Interventional Radiology University of Heidelberg Medical School;

Department of Obstetrics and Gynecology St. Marienkrankenhaus Ludwigshafen Academic Teaching;

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正文语种 eng
中图分类放射医学;
关键词
Dynamic magnetic resonance imaging; pelvic organ prolapse; pelvic organ mobility; quality-of-life questionnaire; vaginal mesh repair;

机译：动态磁共振成像;骨盆器官脱垂;盆腔器官移动性;生活质量问卷;阴道网修复;

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1. Five-year outcome after pelvic floor reconstructive surgery: evaluation using dynamic magnetic resonance imaging compared to clinical examination and quality-of-life questionnaire [J] . Céline D Alt, Laura Benner, Theresa Mokry, Acta Radiologica . 2018,第10期

机译：骨盆楼层重建手术后的五年结果：使用动态磁共振成像进行评估与临床检查和生活质量问卷相比
2. Dynamic magnetic resonance imaging to quantify pelvic organ prolapse: Reliability of assessment and correlation with clinical findings and pelvic floor symptoms [J] . LakemanM.M.E., ZijtaF.M., PeringaJ., International urogynecology journal and pelvic floor dysfunction . 2012,第11期

机译：动态磁共振成像可量化盆腔器官脱垂：评估的可靠性以及与临床表现和盆底症状的相关性
3. Dynamic magnetic resonance imaging to quantify pelvic organ prolapse: reliability of assessment and correlation with clinical findings and pelvic floor symptoms [J] . Mariëlle M. E. Lakeman, F. M. Zijta, J. Peringa, International Urogynecology Journal . 2012,第11期

机译：动态磁共振成像可量化盆腔器官脱垂：评估的可靠性以及与临床表现和盆底症状的相关性
4. Synthetic Mesh Used in Gynecologic Reconstructive Surgery for Pelvic Floor Disorders [C] . BRATILA Elvira, BRATILA Petre, COMANDASU Diana International Conference on Biomaterials, Tissue Engineering and Medical Devices . 2017

机译：骨盆楼盘妇科重建手术中使用的合成网
5. Semi-automatic segmentation of normal female pelvic floor structures from magnetic resonance images. [D] . Li, Xiaolong. 2010

机译：从磁共振图像中正常女性骨盆底结构的半自动分割。
6. Dynamic magnetic resonance imaging to quantify pelvic organ prolapse: reliability of assessment and correlation with clinical findings and pelvic floor symptoms [O] . Mariëlle M. E. Lakeman, F. M. Zijta, J. Peringa, -1

机译：动态磁共振成像可量化盆腔器官脱垂：评估的可靠性以及与临床表现和盆底症状的相关性
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Five-year outcome after pelvic floor reconstructive surgery: evaluation using dynamic magnetic resonance imaging compared to clinical examination and quality-of-life questionnaire

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