Transperineal ultrasound shear-wave elastography is a reliable tool for assessment of the elastic properties of the levator ani muscle in women

Bertrand Gachon,Antoine Nordez,Fabrice Pierre,Xavier Fritel

doi:10.1038/s41598-021-95012-8

Bertrand Gachon, Antoine Nordez + Show 2 more

Open Access

https://doi.org/10.1038/s41598-021-95012-8

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Abstract

Our main objective was to assess the intraoperator intersession reproducibility of transperineal ultrasound Shear Wave Elastography (SWE) to measure the levator ani muscle (LAM) elastic properties. Secondary objective was to compare reproducibility when considering the mean of three consecutives measurements versus one. In this prospective study involving non-pregnant nulliparous women, two visits were planned, with a measurement of the shear modulus (SM) on the right LAM at rest, during Valsalva maneuver and maximal contraction. Assessments were done with a transperineal approach, using an AIXPLORER device with a linear SL 18–5 (5-18 MHz) probe. For each condition, 3 consecutive measures were performed at each visit. The mean of the three measures, then the first one, were considered for the reproducibility by calculating intraclass correlation coefficient (ICC), and coefficient of variation (CV). Twenty women were included. Reproducibility was excellent when considering the mean of the 3 measures at rest (ICC = 0.90; CV = 15.7%) and Valsalva maneuver (ICC = 0.94; CV = 10.6%), or the first of the three measures at rest (ICC = 0.87; CV = 18.6%) and Valsalva maneuver (ICC = 0.84; CV = 19.9%). Reproducibility was fair for measurement during contraction. Transperineal ultrasound SWE is a reliable tool to investigate LAM elastic properties at rest and during Valsalva maneuver.

Highlights

Our main objective was to assess the intraoperator intersession reproducibility of transperineal ultrasound Shear Wave Elastography (SWE) to measure the levator ani muscle (LAM) elastic properties
While the literature suggests an association between pelvic floor muscles and obstetrical pelvic floor damage and /or pelvic floor disorders, this hypothesis remains to be tested in vivo[7,8]
The intraclass correlation coefficient (ICC) was excellent for the intersession reproducibility, considering the mean of the three measures at rest and during the Valsalva maneuver (Table 1)

Summary

Introduction

Our main objective was to assess the intraoperator intersession reproducibility of transperineal ultrasound Shear Wave Elastography (SWE) to measure the levator ani muscle (LAM) elastic properties. Secondary objective was to compare reproducibility when considering the mean of three consecutives measurements versus one In this prospective study involving non-pregnant nulliparous women, two visits were planned, with a measurement of the shear modulus (SM) on the right LAM at rest, during Valsalva maneuver and maximal contraction. Abbreviations BMI Body Mass Index CV Coefficient of variation ICC Intraclass correlation coefficient LAM Levator ani muscle PFD Pelvic floor disorders SEM Standard error of measurement SM Shear modulus SWE Shear wave elastography. The pathophysiology of PFDs is complex, some of these disorders may be explained by vaginal delivery, which can induce pelvic floor damage involving the levator ani muscle (LAM) and/or anal sphincter in up to 15% of women[2,3]. They require an intravaginal intrusive examination, and it remains an indirect measurement on pelvic floor muscles elastic properties (based on the force exerted on the probe/speculum)[2,11]

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