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| MRI-based three-dimensional reconstruction of pelvic levator ani muscle and bony pelvis on male patients with rectal prolapse |
| CUI Guoce1 LI Yufei2 LI Huashan2 |
1.Department of Proctology, South District, Guang′anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 102618, China;
2.Department of Proctology, Guang′anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China |
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Abstract Objective To study the three-dimensional reconstruction of pelvic levator supporting tissue (levator ani muscle and bony pelvis) based on magnetic resonance imaging (MRI), and to observe and measure the parameters of two-dimensional MRI images and three-dimensional models of levator ani muscle and pelvic reconstruction. Methods From October 2016 to December 2018, 11 male patients admitted to Guang′anmen Hospital and South District, Guang′anmen Hospital, China Academy of Chinese Medical Sciences with rectal prolapse as the main diagnosis were selected as the observation group, and 13 healthy male volunteers were recruited as the control group at the same time. MRI scan was performed in both groups to observe original data on levator ani muscle hiatus shape, iliococcygeus form and break of levator ani muscle. Mimics 19.0 three-dimensional reconstruction software was used for three-dimensional reconstruction, and morphological characteristics of three-dimensional models of levator ani muscle and bony pelvis were observed. The levator hiatus width (LHW), levator hiatus length (LHL), levator symphysis gap of left and right side (LSG-L, LSG-R), levator plate angle (LPA), levator ani muscle volume (LVOL), iliococcygeus width of left and right side (ICW-L, ICW-R), iliococcygeal angle of left and right side (ICA-L, ICA-R), pubococcygeal line (PCL), pubic arch angle (PAA), interspinous diameter (IS), intertuberous diameter (IT) were compared and measured. Results Compared with the control group, the levator ani muscle hiatus shape, iliococcygeus form in the observation group were changed to some extent, and the levator ani muscle had a large degree of rupture defect. Compared with the control group, LHW, LHL, LSG-L, LSG-R, LPA were increased, LVOL was decreased in the observation group, the differences were statistically significant (P < 0.05). The differences of ICW-L, ICW-R, ICA-L, ICA-R between the two groups were not statistically significant (P > 0.05). PCL and IT in the observation group were higher than those of the control group, the differences were statistically significant (P < 0.05). The differences of IS and PAA between the two groups were not statistically significant (P > 0.05). Conclusion MRI two-dimensional and three-dimensional data sets reflect the spatial structure and adjacent relationship of pelvic levator ani muscle between healthy men and male patients with rectal prolapse, and evaluate the functional status of pelvic levator supporting structure, which provides an important reference for clinical classification diagnosis, surgical method selection and postoperative efficacy evaluation.
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