E-Posters-Appearance of the Levator Ani Muscle Subdivisions on Transperineal Ultrasound

Appearance of the Levator Ani Muscle Subdivisions on Transperineal Ultrasound - Claudia Manzini, MD

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The levator ani muscle (LAM) consists of subdivisions that are difficult to differentiate on imaging. However, identifying these subdivisions allows for better analysis of the LAM and a better understanding of its role in pelvic floor disorders. Previous studies have successfully differentiated between subdivisions on MRI and endovaginal ultrasound. In this study, the researchers aimed to identify LAM subdivisions using 3D transperineal ultrasound (TPUS). The study was conducted in three phases, using TPUS datasets from nulliparae with symptoms of overactive pelvic floor. The researchers first used TPUS to familiarize themselves with the anatomy of the LAM subdivisions. They then segmented multiple structures, including the pubic bone, puboperineal muscle, anal sphincter, levator arch, puborectal muscle, puboanal muscle, iliococcygeal muscle, and pubovaginal muscle, on TPUS images to create 3D models. Finally, they analyzed the overlap between observers in the segmentation of certain structures. The results showed that all LAM subdivisions were successfully identified on TPUS, resulting in consistent 3D models. The mean overlap between observers was 80% for the puborectal muscle, 71% for the iliococcygeal muscle, and 68% for the puboanal muscle. This study paves the way for future research on the role of different parts of the LAM in pelvic floor disorders.

Keywords

levator ani muscle

LAM subdivisions

imaging

pelvic floor disorders

3D transperineal ultrasound

TPUS datasets

puborectal muscle

puboanal muscle

iliococcygeal muscle

segmentation