本文選題：磁共振成像　切入點(diǎn)：三維重建　出處：《中國實(shí)用婦科與產(chǎn)科雜志》2017年10期

【摘要】：目的利用三維磁共振(3D MRI)重建技術(shù)分析妊娠和分娩是否改變初產(chǎn)婦骨盆大小及產(chǎn)后骨盆的恢復(fù)情況。方法采集2013年1月至2016年11月在南方醫(yī)科大學(xué)南方醫(yī)院檢查的120例未育女性,240例足月單胎初產(chǎn)婦MRI原始數(shù)據(jù),其中73例初產(chǎn)婦產(chǎn)后復(fù)查MRI。分別重建未育女性和初產(chǎn)婦產(chǎn)前、產(chǎn)后骨盆三維模型,測量骨盆大小及形態(tài)并分組比較。結(jié)果 (1)妊娠晚期孕婦與未育女性臨床骨盆分型占比均為:女型猿型扁型男型,足月孕婦骨盆橫徑略微增大(0.2~0.3 cm);恥骨弓角度增大而骨盆傾斜度減小。(2)不同分娩方式產(chǎn)后骨盆變化不同,順產(chǎn)后42 d中骨盆前后徑稍增(0.2 cm),產(chǎn)后6個(gè)月后恢復(fù)至未育大小;剖宮產(chǎn)后骨盆徑線無明顯變化。(3)骶髂關(guān)節(jié)間隙和恥骨聯(lián)合間隙妊娠晚期較未育狀態(tài)增寬,產(chǎn)后42 d減小。至產(chǎn)后6個(gè)月恥骨聯(lián)合間隙恢復(fù)至未育狀態(tài)水平,而骶髂關(guān)節(jié)間隙與妊娠晚期無明顯變化。結(jié)論初產(chǎn)婦骨盆在妊娠和分娩過程中具有一定的穩(wěn)定性和可塑性,妊娠期骨盆的變化有利于經(jīng)陰道分娩,不同分娩方式對骨盆影響不同,產(chǎn)后6個(gè)月初產(chǎn)婦骨盆徑線大部分恢復(fù)至妊娠晚期狀態(tài)。
[Abstract]:Objective to analyze whether the size of the pelvis and the recovery of the postpartum pelvis were changed during pregnancy and delivery by using 3D MRI reconstruction.Methods from January 2013 to November 2016, the original data of MRI were collected from 240 pregnant women with term single birth, including 73 primiparas. The data were collected from Southern Hospital of Southern Medical University.Three dimensional models of pre- and postpartum pelvis were reconstructed, and the size and shape of pelvis were measured and compared.Results 1) the proportion of clinical pelvic types of pregnant women and unfertile women were: female ape type male type.The transverse diameter of pelvis of full-term pregnant women increased slightly (0.2 ~ 0.3 cm), and the pubic arch angle increased and the inclination of pelvis decreased. 2) the changes of pelvis were different in different delivery modes, and the diameter of the pelvis increased slightly to 0.2 cm 路cm ~ (-1) in 42 days after delivery, and recovered to the unfertile size 6 months after delivery.There was no obvious change of pelvic line after cesarean section. (3) the space between sacroiliac joint and pubic joint was wider in late pregnancy than in unfertile state, and decreased at 42 days postpartum.At 6 months postpartum, the pubic symphysis space returned to the unfertile level, but the sacroiliac joint space did not change significantly in the third trimester of pregnancy.Conclusion the pelvis of primipara has certain stability and plasticity during pregnancy and delivery. The change of pelvis during pregnancy is beneficial to vaginal delivery, and different delivery modes have different effects on pelvis.At the beginning of 6 months postpartum, most of the pelvic diameters returned to the state of late pregnancy.
【作者單位】： 南方醫(yī)科大學(xué)南方醫(yī)院婦產(chǎn)科;南方醫(yī)科大學(xué)南方醫(yī)院影像科;
【基金】：國家自然科學(xué)基金(81370736,81571422);國家自然科學(xué)基金重大項(xiàng)目(61190120,61190122) 南方醫(yī)科大學(xué)臨床重點(diǎn)研究項(xiàng)目(LC2016ZD019) 南方醫(yī)科大學(xué)南方醫(yī)院高層次匹配課題(2013020);南方醫(yī)科大學(xué)南方醫(yī)院院級教育基金(14NJMS06)
【分類號】：R714

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