应用磁共振三维重建技术分析妊娠和分娩是否影响初产妇骨盆大小

发布时间：2018-04-03 03:36

本文选题：磁共振成像　切入点：三维重建　出处：《中国实用妇科与产科杂志》2017年10期

【摘要】：目的利用三维磁共振(3D MRI)重建技术分析妊娠和分娩是否改变初产妇骨盆大小及产后骨盆的恢复情况。方法采集2013年1月至2016年11月在南方医科大学南方医院检查的120例未育女性,240例足月单胎初产妇MRI原始数据,其中73例初产妇产后复查MRI。分别重建未育女性和初产妇产前、产后骨盆三维模型,测量骨盆大小及形态并分组比较。结果 (1)妊娠晚期孕妇与未育女性临床骨盆分型占比均为:女型猿型扁型男型,足月孕妇骨盆横径略微增大(0.2~0.3 cm);耻骨弓角度增大而骨盆倾斜度减小。(2)不同分娩方式产后骨盆变化不同,顺产后42 d中骨盆前后径稍增(0.2 cm),产后6个月后恢复至未育大小;剖宫产后骨盆径线无明显变化。(3)骶髂关节间隙和耻骨联合间隙妊娠晚期较未育状态增宽,产后42 d减小。至产后6个月耻骨联合间隙恢复至未育状态水平,而骶髂关节间隙与妊娠晚期无明显变化。结论初产妇骨盆在妊娠和分娩过程中具有一定的稳定性和可塑性,妊娠期骨盆的变化有利于经阴道分娩,不同分娩方式对骨盆影响不同,产后6个月初产妇骨盆径线大部分恢复至妊娠晚期状态。
[Abstract]:Objective to analyze whether the size of the pelvis and the recovery of the postpartum pelvis were changed during pregnancy and delivery by using 3D MRI reconstruction.Methods from January 2013 to November 2016, the original data of MRI were collected from 240 pregnant women with term single birth, including 73 primiparas. The data were collected from Southern Hospital of Southern Medical University.Three dimensional models of pre- and postpartum pelvis were reconstructed, and the size and shape of pelvis were measured and compared.Results 1) the proportion of clinical pelvic types of pregnant women and unfertile women were: female ape type male type.The transverse diameter of pelvis of full-term pregnant women increased slightly (0.2 ~ 0.3 cm), and the pubic arch angle increased and the inclination of pelvis decreased. 2) the changes of pelvis were different in different delivery modes, and the diameter of the pelvis increased slightly to 0.2 cm 路cm ~ (-1) in 42 days after delivery, and recovered to the unfertile size 6 months after delivery.There was no obvious change of pelvic line after cesarean section. (3) the space between sacroiliac joint and pubic joint was wider in late pregnancy than in unfertile state, and decreased at 42 days postpartum.At 6 months postpartum, the pubic symphysis space returned to the unfertile level, but the sacroiliac joint space did not change significantly in the third trimester of pregnancy.Conclusion the pelvis of primipara has certain stability and plasticity during pregnancy and delivery. The change of pelvis during pregnancy is beneficial to vaginal delivery, and different delivery modes have different effects on pelvis.At the beginning of 6 months postpartum, most of the pelvic diameters returned to the state of late pregnancy.
【作者单位】：南方医科大学南方医院妇产科;南方医科大学南方医院影像科;
【基金】：国家自然科学基金(81370736,81571422);国家自然科学基金重大项目(61190120,61190122) 南方医科大学临床重点研究项目(LC2016ZD019) 南方医科大学南方医院高层次匹配课题(2013020);南方医科大学南方医院院级教育基金(14NJMS06)
【分类号】：R714

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