本文選題：肛提肌 + MRI成像　； 參考：《河北聯(lián)合大學(xué)》2014年碩士論文

【摘要】：目的運(yùn)用MRI影像學(xué)技術(shù)，結(jié)合相關(guān)解剖學(xué)知識(shí)，對(duì)不同年齡組女性的正常肛提肌的形態(tài)及功能隨時(shí)間的規(guī)律進(jìn)行研究，在研究正常女性肛提肌的基礎(chǔ)上，研究盆底功能障礙患者的肛提肌各項(xiàng)指標(biāo)的變化。最后利用MRI三維重建技術(shù)建立女性盆底肌肉模型，直觀地展現(xiàn)女性盆底肌肉的立體形態(tài)。 方法1）正常女性肛提肌解剖形態(tài)隨時(shí)間的變化規(guī)律：正常（或至少無(wú)巨大盆腔病變者）女性76例，按不同年齡分組。采用GE7503.0T全身MR掃描儀及研究所需的后處理軟件。觀察正常肛提肌各部分的分布，測(cè)量肛提肌裂隙寬度（LHW）、髂骨尾骨肌厚度（ICT）、髂骨尾骨肌角度（ICA）、提肌板角度（LPA）。采用SPSS13.0對(duì)采集到的數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)處理，分析數(shù)據(jù)變化趨勢(shì)。2）對(duì)盆底功能障礙患者32例行核磁共振盆腔動(dòng)靜態(tài)掃描，通過分析原始圖像，與對(duì)照組比較在肛提肌裂隙寬度（LHW）、髂骨尾骨肌厚度（ICT）、髂骨尾骨肌角度（ICA）、提肌板角度（LPA）方面的差異，總結(jié)盆底功能障礙患者肛提肌的變化特點(diǎn)并做數(shù)據(jù)分析。3）正常女性盆底肌MRI三維重建：將掃描得到的正常女性盆腔MRI圖像數(shù)據(jù)導(dǎo)入制圖軟件，建立盆底肌肉3D模型。直觀地觀察女性盆底肌肉的形態(tài)及毗鄰關(guān)系。 結(jié)果1）正常女性肛提肌的解剖形態(tài)隨時(shí)間的變化規(guī)律研究：隨年齡的增長(zhǎng)正常的提肌板角度變小甚至消失下垂，肛提肌裂孔寬度也隨年齡增長(zhǎng)而變大（P＜0.05），等等。諸如此類的肛提肌退變，都會(huì)造成盆底支撐力量的減弱，從而造成盆底功能的障礙甚至盆腔臟器脫垂。2）盆底功能障礙患者肛提肌解剖及功能的特點(diǎn)：盆底器官脫垂組的肛提肌裂隙寬度明顯大于正常（P＜0.05）；正常對(duì)照組髂骨尾骨肌于靜息和最大腹壓時(shí)較PDF組厚（P＜0.05）；最大腹腔壓力時(shí)， PDF組髂骨尾骨肌角度和提肌板角較正常組明顯增大（P＜0.05）；經(jīng)過最大腹壓作用后，PDF組的髂骨尾骨肌角度及提肌板角度等與靜息狀態(tài)下比較也具有顯著差異（P＜0.05）。3）正常女性盆底肌MRI三維重建：通過建立女性盆底肌肉三維模型，，直觀地觀察到肛提肌的形態(tài)。 結(jié)論MRI影像學(xué)檢查能夠很好地顯示肛提肌的正常或病理形態(tài),動(dòng)態(tài)觀察可以評(píng)估肛提肌的功能改變。此外，以核磁共振為基礎(chǔ)的三維重建技術(shù)，打破了二維圖像局限性，能夠清晰直觀地呈現(xiàn)女性盆底肌肉的立體形態(tài)。
[Abstract]:Objective to study the morphology and function of the normal levator ani muscle in different age groups with the help of MRI imaging technique and related anatomical knowledge, and to study the pattern and function of the normal levator ani muscle in different age groups. To study the changes of various indexes of levator ani muscle in patients with pelvic floor dysfunction. Finally, the female pelvic floor muscle model was established by using MRI 3D reconstruction technique, and the stereoscopic shape of female pelvic floor muscle was displayed intuitively. Methods 1) the changes of anatomic morphology of levator ani muscle with time: 76 normal women (or at least no giant pelvic lesions) were divided into different age groups. GE7503.0T whole-body Mr scanner and post-processing software were used. The distribution of the normal levator ani muscle was observed, the width of the fissure of levator ani muscle was measured, the thickness of the iliac tailbone muscle was ICT10, the angle of the iliac coccyx muscle was ICAI, the angle of the levator muscle plate was measured. 32 patients with pelvic floor dysfunction underwent dynamic and static nuclear magnetic resonance scanning (MRI), and the original images were analyzed by analyzing the original images, using SPSS13.0 to process the collected data statistically and analyze the changing trend of the data. Compared with the control group, there were differences in the width of levator ani muscle (LHWN), the thickness of iliac coccyx muscle (ICTI), the angle of iliac coccyx muscle (ICA), and the angle of levator muscle plate (LPA). The changes of levator ani muscle in patients with pelvic floor dysfunction were summarized and the data were analyzed. 3) MRI reconstruction of normal female pelvic floor muscle was made. The 3D model of pelvic floor muscle was established by importing the MRI image data of normal female pelvic floor into the drawing software. The morphology and adjacent relationship of female pelvic floor muscles were observed intuitively. Results 1) the anatomic morphology of the levator ani muscle in normal women changed with time: the angle of the levator muscle plate decreased or even disappeared with age, and the width of the fissure of levator ani muscle became larger with age (P < 0.05), and so on. The degeneration of the levator ani muscle, such as this, reduces the support strength of the pelvic floor. The anatomic and functional characteristics of levator ani muscle in patients with pelvic floor dysfunction were as follows: the width of fissure of levator ani muscle in pelvic floor organ prolapse group was significantly larger than that in normal group (P < 0.05) and iliac bone tail in normal control group (P < 0.05). At rest and maximum abdominal pressure, skeletal muscle was thicker than PDF group (P < 0.05); at maximum celiac pressure, the angle of iliac coccyx muscle and levator muscle plate in PDF group was significantly larger than that in normal group (P < 0.05); after maximal abdominal pressure, the angle of iliac coccyx muscle and levator muscle plate in PDF group were significantly larger than those in normal group (P < 0.05). There was also significant difference between angle and rest (P < 0.05. 3) MRI reconstruction of normal female pelvic floor muscle: three dimensional model of female pelvic floor muscle was established. The shape of levator ani muscle was observed intuitively. Conclusion MRI imaging can well show the normal or pathological morphology of levator ani muscle, and dynamic observation can evaluate the functional changes of levator ani muscle. In addition, the 3D reconstruction technique based on MRI can break the limitation of two-dimensional image and can clearly and intuitively present the three-dimensional shape of female pelvic floor muscles.
【學(xué)位授予單位】：河北聯(lián)合大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R445.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前5條

1 熊坤林;龔水根;張偉國(guó);;正常肛提肌用力前后SCT、MRI形態(tài)變化研究[J];放射學(xué)實(shí)踐;2007年05期

2 柯桂珠;宋巖峰;陳自謙;馬明;;盆底器官脫垂患者肛提肌的動(dòng)態(tài)MRI研究[J];現(xiàn)代婦產(chǎn)科進(jìn)展;2008年07期

3 王毅,龔水根,張偉國(guó),陳金華,譚勇;正常女性肛提肌解剖與功能的MRI研究[J];醫(yī)學(xué)影像學(xué)雜志;2005年01期

4 李大偉;王麗娜;余宏;權(quán)力;梁家明;;肛提肌MR與CT排便造影的對(duì)照研究[J];醫(yī)學(xué)影像學(xué)雜志;2011年02期

5 單錦露;王閣;王東;雷新;譚立文;張紹祥;;基于數(shù)字化可視人的醫(yī)學(xué)圖像融合研究[J];中國(guó)醫(yī)學(xué)影像技術(shù);2009年01期

相關(guān)博士學(xué)位論文 前1條

1 張景僚;骨盆三維有限元模型的建立及其分析[D];第一軍醫(yī)大學(xué);2007年

相關(guān)碩士學(xué)位論文 前1條

1 莊蓉蓉;盆底功能障礙肛提肌缺損的影像解剖學(xué)研究[D];福建醫(yī)科大學(xué);2011年

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