Abstract：
OBJECTIVE: To investigate the superiority of transrectal high-frequency ultrasound (TRUS) in precise assessment of middle compartment prolapse in comparison with routine transperineal ultrasound (TPUS).
METHODS: Prospectively analyzed and compared detection rates of entire cervical length and uterine descent on TPUS and TRUS in 101 patients with pelvic organ prolapse (POP).
RESULTS: Detection rates of entire cervix on TRUS were significantly higher than those on TPUS both at rest and during Valsalva maneuver (90.10% VS 49.50%, 92.08% VS 9.90% respectively, both p < 0.05). Uterine descent was able to be evaluated in 92.08% of patients by TRUS and in 5.94% of patients by TPUS, which was statistically significant (p < 0.05). The interobserver repeatability for the measurements of anterior lip, cervical canal and posterior lip on TRUS was excellent. The mean lengths of anterior lip, cervical canal and posterior lip were significantly increased during Valsalva maneuver than those measured at rest (p < 0.05). And mean length of anterior lip was longer than posterior lip both at rest and during Valsalva (p < 0.05).
CONCLUSIONS: TRUS can significantly raise detection rates of entire cervix, and make the direct evaluation of uterine descent feasible. TRUS can be used as a complementary method to TPUS to attain more comprehensive and accurate presurgical imaging information in middle compartment prolapse patients.
METHODS: Prospectively analyzed and compared detection rates of entire cervical length and uterine descent on TPUS and TRUS in 101 patients with pelvic organ prolapse (POP).
RESULTS: Detection rates of entire cervix on TRUS were significantly higher than those on TPUS both at rest and during Valsalva maneuver (90.10% VS 49.50%, 92.08% VS 9.90% respectively, both p < 0.05). Uterine descent was able to be evaluated in 92.08% of patients by TRUS and in 5.94% of patients by TPUS, which was statistically significant (p < 0.05). The interobserver repeatability for the measurements of anterior lip, cervical canal and posterior lip on TRUS was excellent. The mean lengths of anterior lip, cervical canal and posterior lip were significantly increased during Valsalva maneuver than those measured at rest (p < 0.05). And mean length of anterior lip was longer than posterior lip both at rest and during Valsalva (p < 0.05).
CONCLUSIONS: TRUS can significantly raise detection rates of entire cervix, and make the direct evaluation of uterine descent feasible. TRUS can be used as a complementary method to TPUS to attain more comprehensive and accurate presurgical imaging information in middle compartment prolapse patients.
摘要：
目的：探讨经直肠高频超声（TRUS）与常规经会阴超声（TPUS）比较，在准确评估中室脱垂方面的优越性。
方法：前瞻性分析并比较了101例盆腔器官脱垂（POP）患者TPUS和TRUS对整个宫颈长度和子宫下降的检出率。
结果：在休息和Valsalva动作期间，TRUS上整个子宫颈的检出率均显着高于TPUS（90.10％VS49.50％，分别为92.08%与9.90%，两者p<0.05)。通过TRUS可以在92.08％的患者中评估子宫下降，通过TPUS可以在5.94％的患者中进行评估，有统计学意义(p<0.05)。前唇测量的观察者间可重复性，TRUS上的宫颈管和后唇表现优异。前唇的平均长度，与静息时相比，Valsalva动作期间的宫颈管和后唇明显增加（p<0.05）。在休息和Valsalva期间，前唇的平均长度均长于后唇（p<0.05）。
结论：TRUS可以显著提高整个宫颈的检出率，并使子宫下降的直接评价成为可行。TRUS可以作为TPUS的补充方法，以获得更全面，更准确的中室脱垂患者的术前影像学信息。
方法：前瞻性分析并比较了101例盆腔器官脱垂（POP）患者TPUS和TRUS对整个宫颈长度和子宫下降的检出率。
结果：在休息和Valsalva动作期间，TRUS上整个子宫颈的检出率均显着高于TPUS（90.10％VS49.50％，分别为92.08%与9.90%，两者p<0.05)。通过TRUS可以在92.08％的患者中评估子宫下降，通过TPUS可以在5.94％的患者中进行评估，有统计学意义(p<0.05)。前唇测量的观察者间可重复性，TRUS上的宫颈管和后唇表现优异。前唇的平均长度，与静息时相比，Valsalva动作期间的宫颈管和后唇明显增加（p<0.05）。在休息和Valsalva期间，前唇的平均长度均长于后唇（p<0.05）。
结论：TRUS可以显著提高整个宫颈的检出率，并使子宫下降的直接评价成为可行。TRUS可以作为TPUS的补充方法，以获得更全面，更准确的中室脱垂患者的术前影像学信息。
