Abstract：
OBJECTIVE: The effects of hysterectomy on pelvic floor function remain uncertain, with the levator ani muscle (LAM) playing a critical role in pelvic support. The levator ani subtended volume (LASV) is an objective measure of the LAM\'s anatomical volume, derived from magnetic resonance imaging (MRI). This study was aimed at assessing the consistency between MRI and computed tomography (CT) in quantifying LASV, and to investigate the effect of hysterectomy on the LAM.
METHODS: This retrospective study analyzed a cohort of 55 hysterectomy patients, utilizing pre-operative pelvic MRI and post-operative CT scans to measure the LASV. To evaluate the consistency between MRI and CT, the study employed the intraclass correlation coefficient and Bland-Altman agreement analysis in a subset of 32 patients with both pre-operative scans. A paired-samplet test was used to analyze LASV changes pre- and post-hysterectomy, and linear regression analysis was performed to account for potential risk factors that may influence post-operative LASV.
RESULTS: High consistency between MRI and CT in measuring LASV was found, with an ICC of 0.911. We observed a significant increase in LASV following hysterectomy, with mean volume pre- and post-operatively of 16.66 cm3 and 18.87 cm3 respectively. Age and body mass index were significant predictors of post-hysterectomy LASV, whereas parity and the type of hysterectomy had no significant impact.
CONCLUSIONS: Hysterectomy significantly affects the LAM, resulting in an increase in post-operative LASV. Moreover, this study verifies that MRI and CT can be used interchangeably for LASV measurements in clinical practice.
METHODS: This retrospective study analyzed a cohort of 55 hysterectomy patients, utilizing pre-operative pelvic MRI and post-operative CT scans to measure the LASV. To evaluate the consistency between MRI and CT, the study employed the intraclass correlation coefficient and Bland-Altman agreement analysis in a subset of 32 patients with both pre-operative scans. A paired-samplet test was used to analyze LASV changes pre- and post-hysterectomy, and linear regression analysis was performed to account for potential risk factors that may influence post-operative LASV.
RESULTS: High consistency between MRI and CT in measuring LASV was found, with an ICC of 0.911. We observed a significant increase in LASV following hysterectomy, with mean volume pre- and post-operatively of 16.66 cm3 and 18.87 cm3 respectively. Age and body mass index were significant predictors of post-hysterectomy LASV, whereas parity and the type of hysterectomy had no significant impact.
CONCLUSIONS: Hysterectomy significantly affects the LAM, resulting in an increase in post-operative LASV. Moreover, this study verifies that MRI and CT can be used interchangeably for LASV measurements in clinical practice.
摘要：
目的：子宫切除术对盆底功能的影响尚不确定，肛提肌（LAM）在骨盆支撑中起着至关重要的作用。肛提提肌对向体积(LASV)是对LAM的解剖体积的客观测量,来自磁共振成像（MRI）。这项研究旨在评估MRI和计算机断层扫描（CT）在量化LASV方面的一致性。并探讨子宫切除术对LAM的影响。
方法：这项回顾性研究分析了55名子宫切除术患者的队列，利用术前盆腔MRI和术后CT扫描测量LASV。评价MRI与CT的一致性,本研究采用了全组相关系数和Bland-Altman一致性分析,对32例患者进行了两种术前扫描.使用配对样本测试来分析子宫切除术前后的LASV变化，并进行线性回归分析,以解释可能影响术后LASV的潜在危险因素.
结果：发现MRI和CT测量LASV的一致性很高，ICC为0.911。我们观察到子宫切除术后LASV显著增加，术前和术后的平均体积分别为16.66cm3和18.87cm3。年龄和体重指数是子宫切除术后LASV的重要预测因素，而产次和子宫切除术的类型没有显著影响.
结论：子宫切除术显著影响LAM，导致术后LASV增加。此外，本研究验证了MRI和CT在临床实践中可交替用于LASV测量.
方法：这项回顾性研究分析了55名子宫切除术患者的队列，利用术前盆腔MRI和术后CT扫描测量LASV。评价MRI与CT的一致性,本研究采用了全组相关系数和Bland-Altman一致性分析,对32例患者进行了两种术前扫描.使用配对样本测试来分析子宫切除术前后的LASV变化，并进行线性回归分析,以解释可能影响术后LASV的潜在危险因素.
结果：发现MRI和CT测量LASV的一致性很高，ICC为0.911。我们观察到子宫切除术后LASV显著增加，术前和术后的平均体积分别为16.66cm3和18.87cm3。年龄和体重指数是子宫切除术后LASV的重要预测因素，而产次和子宫切除术的类型没有显著影响.
结论：子宫切除术显著影响LAM，导致术后LASV增加。此外，本研究验证了MRI和CT在临床实践中可交替用于LASV测量.
