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Analysis of the structure of normal female urethral sphincter complex and levator ani muscles by magnetic resonance diffusion tensor imaging
ZHANG Jing  YANG Zitao  ZHAO Zhiheng  WU Yue  CHENG Jingliang  CHE Yingyu 

Cite this article as: Zhang J, Yang ZT, Zhao ZH, et al. Analysis of the structure of normal female urethral sphincter complex and levator ani muscles by magnetic resonance diffusion tensor imaging[J]. Chin J Magn Reson Imaging, 2022, 13(4): 128-131. DOI:10.12015/issn.1674-8034.2022.04.025.

[Abstract] Objective To explore the influence of delivery and age on the microtissue structure of urethral sphincter complex and levator ani muscles in normal female by 3.0 T MR diffusion tensor imaging, and to provide an objective basis for analyzing the pathogenesis of pelvic floor dysfunction.Materials and Methods Prospectively, 103 women without pelvic floor dysfunction were collected and divided into 24 cases in the normal control group and 79 cases in the menstrual group based on the presence or absence of the history of delivery, and then the menstrual group was divided by age group into those ≤30 years (19 cases), 31-44 years (22 cases), 45-59 years (27 cases) and ≥60 years old group (11 cases). A two-dimensional diffusion-weighted transverse spin-gradient echo (SE-GRE) pulse sequence was used to perform pelvic floor diffusion tensor imaging (DTI) in all subjects, and DTI parameters, including fraction anisotropy (FA), apparent diffusion coefficient (ADC) values, and three eigenvalues (λ1, λ2, and λ3) were measured in the middle urethral circle sphincter, longitudinal muscle, puborectalis muscle, and iliococcygeus muscle fibers to .analyze the effects of delivery history and different age groups on the microstructure of the urethra and levator ani muscles.Results (1) The FA value of the puborectalis muscle in the group under 30 years was smaller than that of the normal control group in the menstrual group, and the difference was statistically significant (t=2.206, P=0.030); (2) There was a statistically significant difference between ADC values, λ2 values and λ3 values of the middle urethral ring sphincter between different age groups in the transmaternal group (F=3.547, 4.105, 3.596, P=0.018, 0.009, 0.017), but there was no statistically significant difference in the DTI parameters of the longitudinal muscle of the middle urethra (P>0.05); (3) In the multiparous women group, the FA value, ADC value, λ1 value and λ2 value of the puborectalis muscle were compared between different age groups, and the differences were statistically significant (F=8.071, 6.051, 6.672, 3.688, P<0.001, P=0.001, P<0.001, P=0.013); (4) In the multiparous female group, the FA value, ADC value and λ3 value of the iliococcygeus muscle were compared between different age groups, and the differences were statistically significant (F=5.676, 3.110, 5.175, P=0.001, 0.028, 0.002).Conclusions Delivery mainly affects the microstructure of the puborectalis muscle, the age factor has a certain influence on the microstructure changes of the urethral annular sphincter and levator ani muscles. DTI technology is of great value in observing the pelvic floor muscle structure and evaluating the microstructure changes.
[Keywords] diffusion tensor imaging;urethral sphincter complex;levator ani muscles;age;delivery;pelvic floor dysfunction

ZHANG Jing   YANG Zitao   ZHAO Zhiheng   WU Yue   CHENG Jingliang   CHE Yingyu*  

Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China

Che YY, E-mail:

Conflicts of interest   None.

Received  2021-12-10
Accepted  2022-04-01
DOI: 10.12015/issn.1674-8034.2022.04.025
Cite this article as: Zhang J, Yang ZT, Zhao ZH, et al. Analysis of the structure of normal female urethral sphincter complex and levator ani muscles by magnetic resonance diffusion tensor imaging[J]. Chin J Magn Reson Imaging, 2022, 13(4): 128-131.DOI:10.12015/issn.1674-8034.2022.04.025

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