Changes in radical line of pelvic floor levator hiatus in female with stress urinary incontience：a MRI study / 中华放射学杂志

ABSTRACT

Objective To investigate the dynamic changes in each radical line of pelvic floor levator hiatus in female with stress urinary incontinence(SUI). Methods A retrospective analysis of MR images was performed in 30 female patients with clinically diagnosed SUI and 30 asymptomatic female volunteers recruited as reference group. All of the subjects underwent pelvic MRI scanning both in static statusand Valsalva maneuver, respectively, Valsalva was performed by attempt to forcibly urinate while holding her breath, respectively. Area of pelvic diaphragm hiatus (LHA), ntero-posterior length (LHL) and tmixmum width (LHW) were measured in horizontal axis plane of the obtained images.H line distance was measured in the midsagittal plane. Independent sample t test was performed to compare the difference in LHA, LHL and LHW between two groups. Paired t test was used to compare difference in LHA, LHL and LHW between two groups in static status and Valsalva maneuver, respectively. Results In static status, the values in LHA, LHL, LHW and H line distance for SUI groups were(28.7±19.3) cm2, (7.1±2.2) cm, (4.7± 1.6 ) cm and (5.7±1.1) cm, respectively. The parameters for the reference group were(13.1±3.7)cm2, (5.3± 0.8) cm, (3.4 ± 0.5) cm and (5.7 ± 0.9) cm, respectively. The difference in LHA, LHL, LHW between two groups was statistically significant (t=4.33, 4.36, 4.23, and P 0.05. In Valsalva maneuver, LHA, LHL, LHW and H line distance were (40.0±26.0) cm2, (8.0±2.3) cm, (6.0±2.5) cm and (6.1± 1.5)cm for SUI group, and were (16.2±6.2) cm2,(5.5±1.0) cm, (3.6±0.8) cm and (6.0±1.0) cm for the reference group, respectively. The difference in LHA, LHL and LHW between two groups was statistically significant, (t=4.88, 5.36, 4.91 respectively, and P<0.01), whereas the differencein H value between two groups was no statistically significant (P< 0.05). For SUI group , the difference of LHA, LHL and LHW between static status and Valsalva maneuver had statistically significant with P<0.01. For reference group, the difference of LHA and LHL between static status and Valsalva maneuver had statistically significant(P<0.05). Conclusion Dynamic and static pelvic MRI can evaluate the morphology and variation of pelvic floor levator hiatus much intuitively and accurately. pelvic floor levator hiatus becomes enlarged in female with SUI.