Is curved three-dimensional ultrasound reconstruction needed to assess the warped pelvic floor plane?
| Autor: | M. Cavalera, Giovanni Morganelli, Nicola Rizzo, G. Pacella, Elisa Montaguti, Aly Youssef, Gianluigi Pilu, I. Cataneo, Ginevra Salsi |
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| Rok vydání: | 2017 |
| Předmět: |
education.field_of_study
Reproducibility 030219 obstetrics & reproductive medicine Pelvic floor Radiological and Ultrasound Technology Plane (geometry) business.industry Population 3D reconstruction Obstetrics and Gynecology General Medicine Anatomy 03 medical and health sciences 0302 clinical medicine Levator ani medicine.anatomical_structure Reproductive Medicine Coronal plane medicine Radiology Nuclear Medicine and imaging 030212 general & internal medicine Image warping education business Nuclear medicine |
| Zdroj: | Ultrasound in Obstetrics & Gynecology. 50:388-394 |
| ISSN: | 0960-7692 |
| Popis: | Objectives Caudal distension of female pelvic floor is common and results in perineal descent and a caudally curved hiatus (so called ‘warping’). All the available ultrasound techniques to date however aim to reconstruct the pelvic floor using linear techniques (flat plane reconstruction). We aimed to evaluate the feasibility, reproducibility and potential usefulness of a new 3D technique, capable of reconstructing a curved plane of the levator hiatus. Methods We recruited a group of primiparous women to perform a 3D/4D transperineal ultrasound 3-6 months after delivery. We evaluated the levator ani warping under Valsalva's maneuver as the distance between the plane running between the pubic rami to anorectal angle and the plane of minimal hiatal dimensions on the coronal plane. Warping distance was used to reconstruct a curved plane using curved Omniview-Volume Contrast Imaging (VCI) technique (C-OV). We assessed intra-, interobserver reproducibility of C-OV as well as intermethod agreement between curved and linear Omniview-VCI (L-OV) for the measurement of pelvic hiatal area under Valsalva. Results Among the 84 women recruited measuring hiatal area using C-OV was feasible in all cases. The warping distance ranged from -3.5 to 9.7 mm, confirming that the traditionally used 1-2 cm-thick linear reconstruction is adequate for proper assessment of pelvic hiatal area in our population. C-OV showed excellent intra, interobserver reproducibility, as well as excellent agreement with the L-OC technique. No systematic difference in any of the performed reproducibility studies. Conclusions 3D reconstruction of the “warped” levator ani muscle plane is feasible and highly reproducible. In our population, the reconstruction of a curved plane to correct for levator ani warping did not offer any benefit in comparison with the traditionally performed linear reconstruction technique. |
| Databáze: | OpenAIRE |
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