Feasibility study of transvaginal biplanar convex ultrasound for evaluating levator ani muscle.

OBJECTIVE

To investigate the clinical feasibility and value of transvaginal biplanar convex ultrasound for evaluating the levator ani muscle (LAM).

METHODS

This prospective cross-sectional study enrolled 130 Chinese women undergoing pelvic floor ultrasound examinations. One doctor (operator 1) performed transperineal three-dimensional ultrasound for tomographic ultrasound imaging (TUI) of the LAM. Concurrently, transvaginal biplanar convex ultrasound was used to assess LAM continuity and thickness, measuring the thickness of the attachment and middle portions and the anal canal level. Seven days later, the same doctor (operator 1) and another doctor (operator 2) repeated the LAM thickness measurements. Cohen's kappa coefficient and intraclass correlation coefficients (ICCs) were calculated to analyze the results.

RESULTS

Transvaginal biplanar convex ultrasound demonstrated excellent consistency with TUI for diagnosing LAM avulsion (Cohen's kappa = 0.74, 95% CI 0.50-0.98). Thickness measurements of each specified segment exhibited excellent intraobserver and good interobserver repeatability (ICC = 0.82-0.86 and 0.74-0.77, respectively). Bland-Altman analysis indicated good consistency between the two operators' measurements.

CONCLUSIONS

Transvaginal biplanar convex ultrasound is a simple, reliable imaging screening method for LAM evaluation.