基于超声弹性成像的女性盆底肌肉定量评估方法

doi:10.3969/j.issn.0258-8021.2017.04.003

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摘要女性盆底功能障碍性疾病是中老年女性的常见疾病,现已成为威胁女性健康的5种常见慢性疾病之一。盆底支撑结构中,盆底肌肉群的支撑作用至关重要,因此盆底肌肉评估对于女性盆底功能障碍性疾病的诊疗具有重要的临床价值。提出一种无创客观的肌肉运动分析方法,基于经会阴超声检测手段,同步获取50例具有不同脱垂程度女性主动收缩肌肉时的超声视频数据及阴道内压数据,应用二维弹性成像算法追踪盆底肌位移场,提取特征点的位移曲线,对比分析能有效完成指定动作的37例不同脱垂程度患者的位移结果,发现提取接近耻骨处特征点的切向位移参数(M_Pu)与临床脱垂测量参数(L_BP)具有相关性(r=-0.93),同时通过在指定的肌肉慢缩运动中的肌力维持时间均值和最大厚度均值对盆底肌的持续控制能力进行评估,结果与被试临床脱垂分级表现具有显著相关性。结果表明,这种方法可实现对盆底肌肉自身生物力学特性的客观定量评估,为临床脱垂诊断提供重要的参考价值。

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	黄帅
	李灵
	练莉
	郭娟
	陶子
	朱超超
	王慧芳
	陆敏华

关键词 ：盆腔器官脱垂, 肛提肌, 弹性成像, 肌肉评估

Abstract：Female pelvic floor dysfunction is a common disease which has become one of the five common chronic diseases threatening women's health. As one of supporting structures, pelvic floor muscle is critical to support the pelvic organs, maintain continence and prevent prolapse. Quantitative evaluation of pelvic floor muscle biomechanics is of great value for the diagnosis and treatment of female pelvic floor dysfunction. Our study aims to propose a noninvasive, quantitative and objective method for motion analysis of the pelvic floor muscles. Ultrasound data and force data during continuous contractive activitieswere simultaneously collected based on transperineal ultrasound scanners from 50 subjects. A two-dimensional motion tracking algorithm was used to monitor the motion of the pelvic floor muscles. Muscle displacement field was then computed. The parameter defined as M_Pu that is the tangential displacements of one interested point near pubis from the valid data of 37 subjects, showed good correlation with clinical measurement parameter (L_BP) (r=-0.93). The continuous control ability of the pelvic muscles was further evaluated by measuring the average maintain time of the maximal contraction force and the maximum muscle thickness. Both of them were computed from the valid data of 37 subjectsand showed good correlation with the clinical grading result of prolapse. It is concluded that ultrasound measurements of tissue motions and biomechanics are of great value for clinical pelvic floor prolapse diagnosis.

Key words： pelvic organ prolapse pelvic floor muscle elastography muscle assessment

收稿日期: 2016-08-14

PACS:

R318

基金资助:国家自然科学基金(61471243);深圳市科技计划(SGLH20131010163759789, JCYJ20150731160834611, JCYJ20140414170821323)

通讯作者: luminhua@szu.edu.cn

引用本文:

黄帅,李灵,练莉,郭娟,陶子,朱超超,王慧芳,陆敏华. 基于超声弹性成像的女性盆底肌肉定量评估方法[J]. 中国生物医学工程学报, 2017, 36(4): 401-409.
Huang Shuai, Li Ling, Lian Li, Guo Juan, Tao Zi, Zhu Chaochao, Wang Huifang, Lu Minhua. A Novel Method for Quantitative Evaluation of Female Pelvic Floor Muscle Using Ultrasound Elastography. Chinese Journal of Biomedical Engineering, 2017, 36(4): 401-409.

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http://cjbme.csbme.org/CN/10.3969/j.issn.0258-8021.2017.04.003 或 http://cjbme.csbme.org/CN/Y2017/V36/I4/401

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