Transperineal ultrasound shear-wave elastography is a reliable tool for assessment of the elastic properties of the levator ani muscle in women

Abstract

Our main objective was to assess the intraoperator intersession reproducibility of transperineal ultrasound Shear Wave Elastography (SWE) to measure the levator ani muscle (LAM) elastic properties. Secondary objective was to compare reproducibility when considering the mean of three consecutives measurements versus one. In this prospective study involving non-pregnant nulliparous women, two visits were planned, with a measurement of the shear modulus (SM) on the right LAM at rest, during Valsalva maneuver and maximal contraction. Assessments were done with a transperineal approach, using an AIXPLORER device with a linear SL 18–5 (5-18 MHz) probe. For each condition, 3 consecutive measures were performed at each visit. The mean of the three measures, then the first one, were considered for the reproducibility by calculating intraclass correlation coefficient (ICC), and coefficient of variation (CV). Twenty women were included. Reproducibility was excellent when considering the mean of the 3 measures at rest (ICC = 0.90; CV = 15.7%) and Valsalva maneuver (ICC = 0.94; CV = 10.6%), or the first of the three measures at rest (ICC = 0.87; CV = 18.6%) and Valsalva maneuver (ICC = 0.84; CV = 19.9%). Reproducibility was fair for measurement during contraction. Transperineal ultrasound SWE is a reliable tool to investigate LAM elastic properties at rest and during Valsalva maneuver.

Shear-wave Elastography Measures of Pelvic Floor Muscle Correlated with Transabdominal Ultrasound Measures of Bladder Displacement for Assessing Pelvic Floor Function

“…Our results can most directly be compared with those of Gachon et al (2021), who assessed the elastic properties of the LA using SWE in a population with similar characteristics. They reported a shear modulus of 21.9-22.8 and 55.1-61.4 kPa at rest and during contraction, respectively, while our results revealed an average of 24.7 and 62.1 kPa at rest and during contraction, respectively, indicating that the results are similar 20 . Bladder base displacement has also been assessed in previous studies conducted in speci c or mixed populations 2,15,29 .…”

“…Thus, it has been used to evaluate the mechanical properties of muscles and to detect tissue elasticity 20,21 . It has also been used to assess the elastic properties of PFM in non-pregnant women in neutral and stretched positions 19 .…”

“…Dynamic elastography methods based on ultrasonic imaging modalities have been developed to evaluate the mechanical properties of biological tissues. Shear-wave elastography (SWE) is an elastography method which uses shear waves by calculating their propagation velocity using imaging techniques 19,20 .…”

Does aging affect the elastic properties of the bladder and the urethra in nulliparous women: An ultrasound shear‐wave elastography study

“…To date, only a few studies have been proposed to explore the elasticity of the pelvic floor and its different components. [20][21][22][23][24] The primary aim of this study was to explore if aging in the absence of pregnancy and childbirth is associated with changes in the elasticity of the different components of the bladder and urethra. The secondary aim of the study was to explore the elasticity differences according to menopausal status and correlate with urinary symptoms.…”

“…The use of SWE in the pelvic floor has only been scarcely studied. To date, only a few studies have been proposed to explore the elasticity of the pelvic floor and its different components 20–24 …”