三维超声联合剪切波弹性成像评估压力性尿失禁绝经女性耻骨直肠肌功能

Objective: To observe the value of three-dimensional ultrasound and shear wave elastography (SWE) for evaluating the function of puborectalis in postmenopausal women with stress incontinence (SI). Methods: Fifty-seventh postmenopausal women with SI (SI group) and 30 postmenopausal women without obvious abnormalities in physical examination (control group) were enrolled. The parameters of levator hitus (LH), including area, anterior and posterior diameter, left and right diameter were measured with three-dimensional transperineal ultrasound. The thickness and mean Young's modulus (E_mean) of puborectalis were measured with high frequency ultrasound and SWE. The above parameters were compared between groups. Results: There was no significant difference of area, anterior and posterior diameter, nor left and right diameter of LH between groups under resting-state (all P>0.05). The area, anterior and posterior diameter and left and right diameter of LH of SI group were higher than those of control under the maximum pelvic floor contraction (all P<0.05). The thickness and E_mean of puborectalis of SI group were lower than those of control group (all P<0.05). Under the maximum pelvic floor contraction, the thickness and E_mean of puborectalis of SI group and control group were higher than those under resting-state (all P<0.05). The area of LH was not significantly correlated with E_mean of left and right puborectalis (left r=-0.182, P=0.108; right r=-0.274, P=0.053) at resting-state, but lowly negatively correlated with E_mean of left and right puborectalis (left r=-0.349, P=0.002; right r=-0.329, P=0.003). Conclusion Three-dimensional ultrasound combined with SWE could be used to evaluate the function of puborectalis in postmenopausal women through observation on LH morphology, thickness and E_mean of puborectalis, which was helpful to early diagnosis and treatment of SI.