A new simple technique for 3-dimensional sonographic assessment of the pelvic floor muscles
Abstract
OBJECTIVES: The purpose of this study was to assess the reproducibility of a new technique for 3-dimensional (3D) pelvic floor sonography: OmniView combined with Volume Contrast Imaging (VCI; GE Healthcare, Kretz Ultrasound, Zipf, Austria) for pelvic hiatal area measurement. In addition, we aimed to study the intermethod agreement between the new technique and the standard 3D rendering method. METHODS: We acquired a static 3D sonographic transperineal volume from 124 nulliparous asymptomatic women and 118 women with symptoms of pelvic floor dysfunction. Each 3D data set was analyzed by the OmniView-VCI technique to measure the pelvic hiatal area twice by one operator and once by another to assess intraobserver and interobserver reproducibility. The first operator later measured the hiatal area using the 3D rendering method to evaluate intermethod agreement. Reproducibility and intermethod agreement were studied by the intraclass correlation coefficient and Bland-Altman method. RESULTS: Hiatal area measurements by the OmniView-VCI technique showed high intraobserver and interobserver reproducibility in both asymptomatic and symptomatic women. In addition, high agreement was shown between the new technique and 3D rendering in both groups. No systematic differences were noted in any of the reliability studies performed. The new technique took slightly less time to calculate the hiatal area than the standard rendering method in both asymptomatic and symptomatic women. CONCLUSIONS: OmniView-VCI is a reliable method for pelvic hiatal area measurement. Further studies are needed to assess its reliability under contraction and the Valsalva maneuver and to evaluate its usefulness and reproducibility for diagnosis of levator ani lesions.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A mini-invasive laparoscopic or robot-assisted laparoscopic approach is strongly recommended for endometriosis.
“In the case of endometriosis, a mini-invasive laparoscopic or laparoscopic approach using a robot is strongly recommended [108].”
From Endometriosis: Epidemiology, Classification, Pathogenesis, Treatment and Genetics (Review of Literature) (2021) · cites this paper as [108]
Cites
Measuring agreement in method comparison studies
Bland, J. M., & Altman, D. G. (1999) · Statistical Methods in Medical Research · doi:10.1177/096228029900800204 · Cited by 9,619 · see citing works
Applying the right statistics: analyses of measurement studies
Bland, J. M., & Altman, D. G. (2003) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.122 · Cited by 1,305 · see citing works
Rankin, G., & Stokes, M. J. (1998) · Clinical Rehabilitation · doi:10.1191/026921598672178340 · Cited by 855 · see citing works
Levator trauma is associated with pelvic organ prolapse
Dietz, H., & Simpson, J. (2008) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2008.01751.x · Cited by 515 · see citing works
Biometry of the pubovisceral muscle and levator hiatus by three‐dimensional pelvic floor ultrasound
Dietz, H. P., Shek, C., & CLARKE, B. (2005) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.1899 · Cited by 506 · see citing works
Ultrasound imaging of the pelvic floor. Part II: three‐dimensional or volume imaging
Dietz, H. P. (2004) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.1072 · Cited by 399 · see citing works
Ballooning of the levator hiatus
Dietz, H. P., Shek, C., León-Luis, J. A. D., & Steensma, A. B. (2008) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.5355 · Cited by 318 · see citing works
Pelvic floor ultrasound: a review
Dietz, H. P. (2010) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2009.08.018 · Cited by 278 · see citing works
Obstetric levator ani muscle injuries: current status
Schwertner-Tiepelmann, N., Thakar, R., Sultan, A. H., & Tunn, R. (2011) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.11080 · Cited by 147 · see citing works
Dietz, H. P., GILLESPIE, A. V. L., & Phadke, P. (2007) · Australian and New Zealand Journal of Obstetrics and Gynaecology · doi:10.1111/j.1479-828x.2007.00748.x · Cited by 138 · see citing works
Validity and reproducibility of the digital detection of levator trauma
Dietz, H. P., & Shek, C. (2008) · International Urogynecology Journal · doi:10.1007/s00192-008-0575-1 · Cited by 134 · see citing works
Tomographic ultrasound imaging of the pelvic floor: which levels matter most?
Dietz, H. P., & Shek, K. L. (2009) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.6403 · Cited by 117 · see citing works
A simplified method for determining hiatal biometry
Dietz, H. P., Wong, V., & Shek, K. L. (2011) · Australian and New Zealand Journal of Obstetrics and Gynaecology · doi:10.1111/j.1479-828x.2011.01352.x · Cited by 100 · see citing works
Pelvic floor trauma following vaginal delivery
Dietz, H. P. (2006) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/01.gco.0000242956.40491.1e · Cited by 95 · see citing works
Diagnosis of levator avulsion injury: a comparison of three methods
Dietz, H. P., Moegni, F., & Shek, K. L. (2012) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.11190 · Cited by 90 · see citing works
The assessment of levator trauma: A comparison between palpation and 4D pelvic floor ultrasound
Dietz, H. P., Hyland, G., & Hay-Smith, J. E. (2006) · Neurourology and Urodynamics · doi:10.1002/nau.20250 · Cited by 80 · see citing works
Falkert, A., Endreß, E., Weigl, M., et al. (2010) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.7563 · Cited by 57 · see citing works
Kruger, J., HEAP, S. W., Murphy, B. A., et al. (2010) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.7750 · Cited by 45 · see citing works
Falkert, A., Willmann, A., Endreß, E., et al. (2012) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.11214 · Cited by 39 · see citing works
Does levator avulsion cause distension of the genital hiatus and perineal body?
Volløyhaug, I., Wong, V., Shek, K. L., & Dietz, H. P. (2012) · International Urogynecology Journal · doi:10.1007/s00192-012-1993-7 · Cited by 38 · see citing works
Clinical consequences of levator trauma
Dietz, H. P. (2012) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.11141 · Cited by 25 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Smolarz, B., Szyłło, K., & Romanowicz, H. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms221910554 · Cited by 560 · see citing works
van den Noort, F., Manzini, C., van der Vaart, C. H., van Limbeek, M. A. J., Slump, C. H., & Grob, A. T. M. (2022) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.24810 · Cited by 25 · see citing works
- Authors
- Youssef, A., Montaguti, E., Sanlorenzo, O., Cariello, L., Awad, E. E., Pacella, G., Ghi, T., Pilu, G., & Rizzo, N.
- Affiliations
- IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola (IT)
- Corresponding author
- Youssef, Aly
- Venue
- Journal of Ultrasound in Medicine
- Publisher
- Wiley
- Published
- 2015-01
- Volume
- 34
- Issue
- 1
- Pages
- 65-72
- ISSN
- 0278-4297 (ISSN-L)
- 1550-9613
- OpenAlex
- W2130112562
- Cited by
- 48
- References
- 21
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 3 · 2022: 2 · 2021: 10 · 2020: 3 · 2019: 8 · 2018: 6 · 2017: 3 · 2016: 4 · 2015: 3
- FWCI
- 2.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Ultrasound in Medicine (publishedVersion)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Ultrasound in Clinical Applications
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Keywords
- 3D ultrasound, volume contrast imaging, levator ani muscle, pelvic floor dysfunction, transperineal ultrasound, measurement reproducibility, interobserver agreement
- MeSH terms
- Adult, Female, Humans, Middle Aged, Ultrasonography, Reproducibility of Results, Observer Variation, Pelvic Floor, Muscle, Skeletal, Imaging, Three-Dimensional, Pelvic Floor Disorders
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
