Appearance of the Levator Ani Muscle Subdivisions in Endovaginal Three-Dimensional Ultrasonography

Abstract

III.

Interobserver agreement of multicompartment ultrasound in the assessment of pelvic floor anatomy

“…Studies have shown that images obtained using EVUS have good-to-very good correlation in cadaveric sections for pelvic floor muscle subdivisions. 10,39 Post-processing of the images acquired on 3D-EVUS facilitates the evaluation of LAM in the plane of minimal hiatal dimensions, and good-to-excellent correlation has been reported in the LH measurements. 8 A recent publication has studied the change in LH dimensions using 3D high-frequency EVUS 1 year before and after treatment for POP and found that in contrast to conservative management, there is a significant decrease in LH dimensions 12 months following surgery.…”

“…3 However, concerns have been raised regarding decisions based on clinical assessment alone, as this may have a limited role in evaluating the morphological and structural changes leading to PFD. 4,5 A review of the literature revealed that the majority of morphologic features of the female genital tract can be identified using ultrasound [6][7][8][9][10][11] and MRI. 12, 13 Dietz et al 6 first described the use of translabial ultrasound to quantify POP and demonstrated a good correlation between imaging, clinical staging and POPQ.…”

Is there a correlation between levator ani and urethral sphincter complex status on 3D ultrasonography?

“…The levator ani muscle is arranged in a unique threedimensional structure that makes it accessible by ultrasonography [11,12] and magnetic resonance imaging (MRI) [13,14]. In the same way, the urethral sphincter musculature can also be easily visualized and readily measured using endovaginal ultrasonography (EVUS) [15,16], intraurethral ultrasonography [17,18] and MRI [19][20][21].…”

Anterior and posterior compartment 3D endovaginal ultrasound anatomy based on direct histologic comparison

“…Seminal studies in the early 1990s demonstrated the relevance of endoanal US and EVUS in evaluating anal sphincter injury [16][17][18][19]. We published the utility of 3D EVUS for visualizing the levator ani anatomy in 2009 [20,21]. The aim of the study reported here was to validate the use of 3D EVUS as a novel and emerging technology for evaluating anterior and posterior compartment structures.…”