3D Ultrasound Strain Imaging of Puborectalis Muscle

Das, Shreya; Hansen, Hendrik H.G.; Hendriks, Gijs; Noort, Frieda van den; Manzini, Claudia; Vaart, C. H. van der; Korte, Chris L. de

doi:10.1016/j.ultrasmedbio.2020.11.016

Cited by 8 publications

(20 citation statements)

References 40 publications

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“…Additionally, having identified and segmented the different LAM subdivisions, TPUS-based biomechanical analyses can be applied on intact LAM. Das et al [ 35 ] used the PRM segmentations from this study and successfully estimated 3D displacement and strain of the PRM, which has not been reported in literature before. These strain and displacement measurements provide a unique measurement of in vivo movement and function of the LAM and its subdivisions.…”

Section: Discussionmentioning

confidence: 82%

“…With respect to MRI, dynamic MRI does exist but it is much less available than TPUS. The work of Das et al [ 35 ] demonstrates that our study is an important step in the direction of in vivo 3D biomechanical analysis of the pelvic floor function. This analysis could allow for a reliable quantitative assessment of the pelvic floor function to be used for diagnostic purposes and for the assessment of functional changes over time (e.g., during treatment).…”

Section: Discussionmentioning

confidence: 84%

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Appearance of the levator ani muscle subdivisions on 3D transperineal ultrasound

et al. 2021

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Background The levator ani muscle (LAM) consists of different subdivisions, which play a specific role in the pelvic floor mechanics. The aim of this study is to identify and describe the appearance of these subdivisions on 3-Dimensional (3D) transperineal ultrasound (TPUS). To do so, a study designed in three phases was performed in which twenty 3D TPUS scans of vaginally nulliparous women were assessed. The first phase was aimed at getting acquainted with the anatomy of the LAM subdivisions and its appearance on TPUS: relevant literature was consulted, and the TPUS scan of one patient was analyzed to identify the puborectal, iliococcygeal, puboperineal, pubovaginal, and puboanal muscle. In the second phase, the five LAM subdivisions and the pubic bone and external sphincter, used as reference structures, were manually segmented in volume data obtained from five nulliparous women at rest. In the third phase, intra- and inter-observer reproducibility were assessed on twenty TPUS scans by measuring the Dice Similarity Index (DSI). Results The mean inter-observer and median intra-observer DSI values (with interquartile range) were: puborectal 0.83 (0.13)/0.83 (0.10), puboanal 0.70 (0.16)/0.79 (0.09), iliococcygeal 0.73 (0.14)/0.79 (0.10), puboperineal 0.63 (0.25)/0.75 (0.22), pubovaginal muscle 0.62 (0.22)/0.71 (0.16), and the external sphincter 0.81 (0.12)/0.89 (0.03). Conclusion Our results show that the LAM subdivisions of nulliparous women can be reproducibly identified on 3D TPUS data.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 84%

Appearance of the levator ani muscle subdivisions on 3D transperineal ultrasound

et al. 2021

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“…Having identified and segmented the different LAM subdivisions, TPUS-based biomechanical analyses can be applied on intact LAM. Das et al [29] used the PRM segmentations from this study and successfully estimated 3D displacement and strain of the PRM, which has not been reported in literature before. This demonstrates that our work is an important step in the direction of TPUS-based 7.5.…”

Section: Discussionmentioning

confidence: 73%

“…Therefore the appearance of the LAM subdivisions was also already successfully identified on EVUS around 10 years ago [27]. TPUS allows for functional analysis like strain measurements [28,29]. Since there is a probe in the vagina, in case of EVUS, the possibility of functional analysis is literally blocked, since muscle contraction is blocked.…”

Section: Mri and Endovaginal Ultrasoundmentioning

confidence: 99%

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Automatic analysis of transperineal ultrasound images

Noort¹

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3D ultrasound strain imaging of puborectal muscle with and without unilateral avulsion

Das¹,

Hendriks²,

Noort

et al. 2023

Int Urogynecol J

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Introduction and hypothesis The puborectal muscle (PRM), one of the female pelvic floor (PF) muscles, can get damaged during vaginal delivery, leading to disorders such as pelvic organ prolapse. Current diagnosis involves ultrasound (US) imaging of the female PF muscles, but functional information is limited. Previously, we developed a method for strain imaging of the PRM from US images in order to obtain functional information. In this article, we hypothesize that strain in the PRM would differ from intact to the avulsed end. Methods We calculated strain in PRMs at maximum contraction, along their muscle fiber direction, from US images of two groups of women, which consisted of women with intact (n1 = 8) and avulsed PRMs (unilateral) (n2 = 10). Normalized strain ratios between both ends of the PRM (avulsed or intact) and the mid region were calculated. Subsequently, the difference in ratio between the avulsed and intact PRMs was determined. Results We observe from the obtained results that the contraction/strain pattern of intact and undamaged PRMs is different from PRMs with unilateral avulsion. Normalized strain ratios between avulsed and intact PRMs were statistically significant (p = 0.04). Conclusion In this pilot study, we were able to show that US strain imaging of PRMs can show differences between intact PRMs and PRMs with unilateral avulsion.

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3D Ultrasound Strain Imaging of Puborectalis Muscle

Cited by 8 publications

References 40 publications

Appearance of the levator ani muscle subdivisions on 3D transperineal ultrasound

Appearance of the levator ani muscle subdivisions on 3D transperineal ultrasound

Automatic analysis of transperineal ultrasound images

3D ultrasound strain imaging of puborectal muscle with and without unilateral avulsion

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