CAJ | 학술논문

目的探讨动态经会阴超声(DTP-US)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DTP-US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.DTP-US与DMRD检查诊断直肠前突的一致性采用Cohen's κ系数检验,DTP-US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 DTP-US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.DTP-US与DMRD检查诊断直肠前突具有充分的一致性(κ =0.737,P＜O.05).DTP-US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).DTP-US与DMRD检查测量直肠前突深度高度相关(|r| =0.874,P＜0.05).随着DTP-US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 DTP-US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.DTP-US因诊断迅速,患者耐受性好而优于DMRD检查.
목적 탐토동태경회음초성(DTP-US)여동태MRI배분조영(DMRD)검사진단직장전돌적일치성,비교저량충진단방법측량직장전돌심도지간적차이성화상관성.방법 회고성분석2011년9월지2012년5월남경중의약대학제삼부속의원수치적18명녀성직장전돌환자적림상자료.대소유환자진행DTP-US여DMRD검사,비교량충진단방법적일치성,병관찰량충방법대분저기타이상정황적검출솔.DTP-US여DMRD검사진단직장전돌적일치성채용Cohen's κ계수검험,DTP-US여DMRD검사측량적직장전돌심도적비교채용배대양본t검험,량자소측량적직장전돌심도적상관성채용Pearson등급상관검험.결과 DTP-US검사진단적14례직장전돌적환자중,합병방광탈수7례、분저실이완5례、자궁탈수2례、직장점막내투첩2례、장산1례;DMRD검사진단적18례직장전돌적환자중,합병방광탈수12례、분저실이완8례、자궁탈수8례、직장점막내투첩6례、장산1례.DTP-US여DMRD검사진단직장전돌구유충분적일치성(κ =0.737,P＜O.05).DTP-US여DMRD검사측량직장전돌적심도분별위(15±6) mm(7～24 mm)화(27 ±7)mm(20～41 mm),량자비교,차이유통계학의의(t=-16.124,P＜0.05).DTP-US여DMRD검사측량직장전돌심도고도상관(|r| =0.874,P＜0.05).수착DTP-US검사소측량적직장전돌심도적증대,DMRD검사소측량적직장전돌심도역수지상응증대(|r|=1.000,P＜0.05).결론 DTP-US여DMRD검사진단직장전돌적일치성고,량자소측량적직장전돌심도지간존재차이화고도상관성.DTP-US인진단신속,환자내수성호이우우DMRD검사.
Objective To evaluate the agreement between dynamic transperineal ultrasound (DTP-US)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 DTP-US 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 DTP-US 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 DTP-US and DMRD in diagnosing rectocele was analysed by Cohen's kappa test.The difference of the depth of rectocele measured by DTP-US and DMRD was compared by paired samplet test,and the correlation of the depth of rectocele measured by DTP-US and DMRD was analyzed by using the Pearson correlation coefficient.Results Of the 14 patients diagnosed by DTP-US,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 DTP-US and DMRD in diagnosing rectocele was obvious (κ =0.737,P ＜ 0.05).The depth of the rectocele detected by DTP-US 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 DTP-US 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 DTP-US (| r | =1.000,P ＜ 0.05).Conclusions The agreement between DTP-US 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 DTP-US is superior to DMRD in terms of quick diagnosis and better telerance of patients.