Ultrasonography for measuring rectus abdominis muscles diastasis

Abstract

Purpose: Preoperative imaging evaluation may be useful for determining the position of recti abdominis muscles before their correction. The purpose of this study is to evaluate the accuracy of ultrasonography to measure the width of rectus abdominis muscle diastasis. Methods: Rectus diastasis was measured by ultrasonography preoperatively in 20 females. Rectus diastasis was measured in seven levels along the anterior rectus sheath by ultrasound after sustained deep inspiration and after expiration. Rectus diastasis, at the same levels, was also measured after its exposition during abdominoplasty by two independent observers, using a surgical compass. These values were compared using Wilcoxon's statistical text, for non independent values. Results: There was no significant difference between the values obtained by ultrasound and those measured during surgery in the supra-umbilical levels and at the level of the umbilicus. However, below the umbilicus these values differed significantly, showing smaller values in the imaging evaluation. Conclusion: Ultrasonography is an accurate method to measure rectus diastasis above the umbilicus and at the umbilical level. Key words: Abdominal Wall. Abdominal Muscles. Ultrasonography. Diagnostic Imaging. Surgery, Plastic. Rectus Abdominis. RESUMO Objetivo:Estudos radiológicos pré-operatórios podem ser úteis para determinar a posição dos músculos retos do abdome antes de sua correção. O objetivo deste estudo é avaliar a acurácia da ultra-sonografia para medir a largura da diástase dos músculos retos do abdome. Métodos: A diástase dos músculos retos foi medida pela ultra-sonografia, no pré-operatório em 20 mulheres. A diástase dos retos foi medida em sete níveis da bainha anterior dos retos foram examinados com ultrasom após inspiração profunda sustentada e após expiração. A diástase dos retos, nos mesmos níveis, foi também medida após sua exposição durante a abdominoplastia, por dois observadores independentes, usando compasso cirúrgico. As medidas foram comparadas usando o teste estatístico de Wilcoxon para dados não independentes. Resultados: Não houve diferença significante entre as medidas ultra-sonográficas e intra-operatórias nos níveis supra-umbilicais e na cicatriz umbilical. Todavia, inferiormente à cicatriz umbilical, essas medidas diferiram significantemente sendo as ultrasonográficas menores nestes pontos. Conclusão: A ultra-sonografia é um método acurado para medir a diástase de retos na região supra-umbilical e no nível do umbigo.

Reliability of the inter-rectus distance measured by palpation. Comparison of palpation and ultrasound measurements

“…Computed tomography (CT) and magnetic resonance imaging (MRI) are currently considered the methods of choice to examine the abdominal wall. However, these methods are expensive and CT exposes the patient to radiation (Mendes et al, 2007), making it impossible to use in pregnant women. Hence, ultrasonography has been proposed as a safe and non-invasive technique that can be repeated several times (Mendes et al, 2007) during pregnancy.…”

“…However, these methods are expensive and CT exposes the patient to radiation (Mendes et al, 2007), making it impossible to use in pregnant women. Hence, ultrasonography has been proposed as a safe and non-invasive technique that can be repeated several times (Mendes et al, 2007) during pregnancy. Coldron et al (2008) used ultrasound to characterize RA changes during the first year postpartum and Mendes et al (2007) claimed ultrasonography to be an accurate method to measure DRA above and at the umbilicus when compared with surgical compass during abdominoplasty.…”

“…Hence, ultrasonography has been proposed as a safe and non-invasive technique that can be repeated several times (Mendes et al, 2007) during pregnancy. Coldron et al (2008) used ultrasound to characterize RA changes during the first year postpartum and Mendes et al (2007) claimed ultrasonography to be an accurate method to measure DRA above and at the umbilicus when compared with surgical compass during abdominoplasty. Recently Mota et al (2012) found very good reliability for IRD measurements with ultrasound.…”

The Relationships Between Inter-recti Distance Measured by Ultrasound Imaging and Abdominal Muscle Function in Postpartum Women: A 6-Month Follow-up Study

“…More recently, ultrasound imaging has been used to measure IRD in postpartum women 9 and women before and after abdominoplasty for postpartum DRA. 20,27 Mendes 20 demonstrated that ultrasonography is an accurate method for measuring IRD. Coldron et al 9 investigated the characteristics of DRA and concluded that ultrasound imaging is a more specific tool for measuring IRD in postpartum women; however, they did not provide specific criteria for the diagnosis of DRA.…”

The effects of a 6 week dynamic core stability plank exercise program compared to a traditional supine core stability strengthening program on diastasis recti abdominis closure, pain, oswestry disability index (ODI) and pelvic floor disability index scores (PFDI)

“…Also, according to Mendes et al, USI was shown to be a valid tool to use in measuring DRA at and above the umbilicus level. The following is a list of significance related values obtained in the following order: "6 cm above (p=0.1292), 3 cm above (p=0.4562), and at umbilicus (p=0.3015)" [11].…”