Abstract:

Objective　To explore the value of transperineal ultrasound combined with shear wave elastography (SWE) in the diagnosis of pelvic floor dysfunction (PFD). Methods　This was a retrospective study. One hundred and twenty patients with PFD treated at Yulin Hospital, The First Affiliated Hospital of Xi'an Jiaotong University from October 2021 to October 2023 were selected as a study group; 82 healthy women who received physical examination during the same period were selected as a control group. All the subjects took transperineal ultrasound and SWE examinations. The general data (age, body mass index, parity, and education level) and parameters of transperineal ultrasound and SWE examinations under different conditions were collected in both groups. The accuracy rates of different examination methods in the diagnosis of PDF were compared. t and χ² tests were use for the statistical comparisons. The receiver operating characteristic curve (ROC) was applied to evaluate the value of transperineal ultrasound combined with SWE in the diagnosis of PFD. Results　There were no statistical differences in age, body mass index, parity, and education level between the two groups (all P>0.05). Under different conditions, the anteroposterior diameter, left-right diameter, and area of anal levator hiatus in the study group were larger than those in the control group, while the Young' s modulus of puborectal muscle (PR) was lower (all P<0.05). The accurate rates of transperineal ultrasound, SWE, and their combination in the detection of PDF were 86.67% (104/120), 90.83% (109/120) , and 97.50% (117/120), respectively; the accurate rate of the combination was higher than those of transperineal ultrasound and SWE (both P<0.05). The ROC results showed that the areas under the curves (AUC) of the anteroposterior diameter, left-right diameter, and area of anal levator hiatus and the Young' s modulus of PR for PFD were 0.622, 0.569, 0.676, 0.638, 0.643, 0.586, 0.680, and 0.694 (all P<0.05), respectively, and the AUC of the combined diagnosis was 0.846 (P<0.05). Conclusion　Transperineal ultrasound combined with SWE has high diagnostic value fir PFD.

Key words: Shear wave elastography,  Transperineal ultrasound,  Pelvic floor dysfunction,  Combined diagnosis

摘要：

目的　探讨经会阴超声联合剪切波弹性成像（SWE）在盆底功能障碍中的诊断价值。方法　采用回顾性研究，选取2021年10月至2023年10月西安交通大学第一附属医院榆林医院收治的120例盆底功能障碍患者作为研究组，另选取同期体检健康的82例女性作为对照组。均接受经会阴超声及SWE检查，收集两组一般资料（年龄、体重指数、产次、文化程度）、不同状态下经会阴超声检查参数［静息与缩肛状态下的裂孔前后径、裂孔左右径、裂孔面积］、SWE检查参数［静息与缩肛状态下的耻骨直肠肌（PR）杨氏模量值］，比较不同检查方法诊断盆底功能障碍的准确率。采用t检验、χ2检验进行统计比较，受试者操作特征曲线（ROC）评估经会阴超声联合SWE对盆底功能障碍的诊断价值。结果　两组研究对象的年龄、体重指数、产次、文化程度比较，差异均无统计学意义（均P>0.05）。不同状态下，研究组肛提肌裂孔前后径、左右径及面积均大于对照组，PR杨氏模量值小于对照组（均P<0.05）。经会阴超声、SWE及两者联合检出盆底功能障碍的准确率分别为86.67%（104/120）、90.83%（109/120）、97.50%（117/120），两者联合的检出准确率明显高于单独应用（均P<0.05）。ROC结果显示，静息与缩肛状态下的裂孔前后径、裂孔左右径、裂孔面积、PR杨氏模量值断盆底功能障碍的曲线下面积（AUC）分别为0.622、0.569、0.676、0.638、0.643、0.586、0.680、0.694（P<0.05），联合诊断的AUC为0.846（均P<0.05）。结论　经会阴超声联合SWE对盆底功能障碍具有较高的诊断价值。

关键词: 剪切波弹性成像； ,  , 经会阴超声； ,  , 盆底功能障碍； ,  , 联合诊断