| Objective(1) To assess levator hiatus using Omniview combined with volume contrast imaging technique in nulliparas and women with pelvic floor dysfunction.(2) Evaluate the feasibility of Omniview-VCI technique in diagnosing levator ani muscle avulsion.Methods(1) Totally 50 nulliparous female and 61 women with pelvic floor dysfunction underwent 3D transperineal ultrasonography of pelvic floor at rest. And the Volume data was analyzed off line. The longitudinal diameter, transverse diameter and area of levator hiatus were measured by two operators using Omniview-VCI. Meanwhile, the hiatal size was measured by one of the two operators using reconstruction rendering (Render) mode. Statistical analysis was performed in order to evaluate the differences between the two imaging methods, intra-and inter-observer reproducibility in both groups.(2) 61 women with pelvic floor dysfunction underwent transperineal 3D ultrasound on levator ani muscle contraction. Blinded and random offline analysis of volume datasets was performed by the means of the Omniview-VCI technique and the standard render method in order to asses if there was any levator ani muscle avulsion.Results(1) No significant differences of levator hiatus longitudinal diameter, transverse diameter and area between the two imaging methods in both groups(all P>0.05). The intra-observer and inter-observer correlation coefficient in both groups were all> 0.8.(2) 6 volumes were judged to be bilateral levator ani muscle avulsion,11 with left, 15 with right by both methods used. On the contrary,8 volumes reported conflicting results. The agreement in the diagnosis of levator avulsion between Omniview-VCI technique and render method was 86.9%. The agreement yielded a kappa of 0.82 with a P value<0.05.ConclusionOmniview-VCI could be a reliable method in the assessment of female levator hiatus and a tool for the diagnosis of levator ani avulsion. |
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