Three-dimensional/four-dimensional transperineal ultrasound: clinical utility and future prospects

Salsi, G.; Cataneo, I.; Dodaro, G.; Rizzo, Nicola; Pilu, Gianluigi; Gascòn, Mar Sanz; Youssef, A.

doi:10.2147/ijwh.s103789

Cited by 29 publications

(27 citation statements)

References 87 publications

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“…LAM avulsion is an important risk factor for POP, and it has been suggested to be the missing link between childbirth and POP . The 3D/4D TPU offers a reliable and accurate tool for the assessment of LAM integrity and function . The gold standard for the diagnosis of levator ani injuries remains the multislice technique (TUI) proposed by Dietz et al In most cases of LAM injury, qualitative evaluation is sufficient to diagnose or exclude the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

The role of a new three‐dimensional ultrasound technique in the diagnosis of levator ani muscle avulsion

Montaguti

Cariello

Dodaro

et al. 2019

Neurourology and Urodynamics

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Aims: To evaluate the intermethod agreement between the tomographic ultrasound imaging (TUI), considered as the gold standard, and the OmniView-VCI in the diagnosis of levator ani muscle (LAM) avulsion and in the measurement of levator-urethral gap (LUG). Methods:We acquired dynamic 4D transperineal ultrasound volumes from 114 women. Each data set was analyzed on maximal pelvic floor contraction by TUI and OmniView-VCI techniques to check for LAM avulsion. Moreover, we measured LUG using both TUI and OmniView-VCI, twice by an operator and once by another to assess intraobserver and interobserver reproducibility.Reproducibility and intermethod agreement were studied by means of intraclass correlation coefficient (ICC) and Cohen's kappa coefficient. Results: In the diagnosis of ani levator avulsion, the two techniques showed a good agreement (Cohen's κ = 0.691, 95% confidence interval [CI], 0.522-0.860; P < .001); we also reported a good intraobserver and interobserver agreement (Cohen's κ = 0.738, 95% CI, 0.597-0.879; P < .001, and Cohen's κ = 0.864, 95% CI, 0.750-0.978; P < .001, respectively). LUG measurements by OmniView-VCI technique showed high intraobserver (ICC 0.895; 95% CI, 0.866-0.918) and interobserver (ICC 0.821; 95% CI, 0.774-0.858) reproducibility. High intermethod agreement was demonstrated between the two methods (ICC 0.813; 95% CI, 0.764-0.853). The area under the receiver-operating characteristic curve of LUG in predicting avulsion was 0.931 (0.868-0.994, 95% CI; P < .001) with 24 mm showing the best sensitivity (82%) and specificity (97%). Conclusions:OmniView-VCI is a reliable method for LUG measurement and for levator avulsion diagnosis. K E Y W O R D S 3D ultrasound, avulsion, levator muscle, pelvic floor, transperineal ultrasound

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Section: Discussionmentioning

confidence: 99%

The role of a new three‐dimensional ultrasound technique in the diagnosis of levator ani muscle avulsion

Montaguti

Cariello

Dodaro

et al. 2019

Neurourology and Urodynamics

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“…Despite the high level of availability and the increasing dissemination of transperineal sonography, relevant measuring points at the transperineal image of the pelvic floor are still missing (the pubis is the one bony structure that retains the position during movement, such as Valsalva) [29,30]. This however leaves too much scope for interpretation.…”

Section: Materials and Methodmentioning

confidence: 99%

New Technique for Pelvic Floor Measurement - Transperineal Dynamic Ultrasound Measurement Method to Detection and Quantification of Rectocele, Cystocele, Enterocele and Perineal Descensus

MJ¹

2018

MSR

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“…Many studies, both in obstetrics and gynecology, have demonstrated that TPU can provide valuable information for the clinician. In gynecology, TPU is a reliable and reproducible tool for static and dynamic assessment of pelvic floor morphology and biometry [1][2][3][4][5][6] . In addition to providing important information in urogynecological patients, TPU has considerably improved our understanding of the relationship between labor and pelvic floor disorders 2,3,[7][8][9][10][11][12] .…”

Section: Introductionmentioning

confidence: 99%

Transperineal ultrasound assessment of maternal pelvic floor at term and fetal head engagement

Youssef

Brunelli

Montaguti

et al. 2020

Ultrasound in Obstet & Gyne

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Objectives To evaluate the association between pelvic floor dimensions in nulliparous women at term and fetal head engagement, as assessed by transperineal ultrasound. Methods This was a prospective observational study of nulliparous women at term. Before the onset of labor, transperineal ultrasound was used to measure the anteroposterior diameter (APD) of the levator hiatus and the angle of progression (AoP) at rest, on maximum pelvic floor muscle contraction and on maximum Valsalva maneuver (before and after visual feedback). We assessed the correlation between pelvic floor static and dynamic dimensions (levator hiatal APD and levator ani muscle coactivation) and AoP, which is an objective index of fetal head engagement. Results In total, 282 women were included in the analysis. Among these, 211 (74.8%) women had a vaginal delivery while 71 (25.2%) had a Cesarean delivery. AoP was narrower in the Cesarean‐delivery group at rest, on maximum pelvic floor muscle contraction and on maximum Valsalva, whereas no differences in levator hiatal APD were found between the two groups. We found a negative correlation between levator hiatal APD at rest, on maximum pelvic floor muscle contraction and on maximum Valsalva and the duration of the second stage of labor. There was a positive correlation between AoP and levator hiatal APD on maximum Valsalva maneuver after visual feedback (r = 0.15, P = 0.01). Women with levator ani muscle contraction on Valsalva maneuver (i.e. coactivation), both pre and post visual feedback, had a narrower AoP at rest and on maximum Valsalva. After visual feedback, women with levator ani muscle coactivation had a longer second stage of labor than did those without (80.8 ± 61.4 min vs 62.9 ± 43.4 min (P = 0.04)). Conclusions Smaller pelvic floor dimensions and levator ani muscle coactivation are associated with higher fetal head station and with a longer second stage of labor in nulliparous women at term. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.

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Three-dimensional/four-dimensional transperineal ultrasound: clinical utility and future prospects

Cited by 29 publications

References 87 publications

The role of a new three‐dimensional ultrasound technique in the diagnosis of levator ani muscle avulsion

The role of a new three‐dimensional ultrasound technique in the diagnosis of levator ani muscle avulsion

New Technique for Pelvic Floor Measurement - Transperineal Dynamic Ultrasound Measurement Method to Detection and Quantification of Rectocele, Cystocele, Enterocele and Perineal Descensus

Transperineal ultrasound assessment of maternal pelvic floor at term and fetal head engagement

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