Volumetric segmentation analysis of the levator ani muscle using magnetic resonance imaging in pelvic floor function assessment

Buz Yaşar, Ayşenur; Yüzok, Rüveyde Begüm; Dağıstan, Emine

doi:10.4274/dir.2024.232586

Cited by 1 publication

(1 citation statement)

References 23 publications

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“…Diagnostics 2024, 14, 923 2 of 17 measurement techniques, such as estimated levator ani subtended volumes [7], volumetric segmentation [10], levator bowl volume [3], aperture size in the anterior pelvis in MRI [11] or measuring the width of the genital hiatus by US [12], have served as surrogate parameters for pelvic organ descent. However, one MR study showed that the association of levator tears and an increase in hiatus size is rather weak, in that only 12% of the variation in levator hiatus is explained by a levator defect [3].…”

Section: Introductionmentioning

confidence: 99%

Quantitative 3D Analysis of Levator Ani Muscle Subdivisions in Nulliparous Women: MRI Feasibility Study

Moser,

Skawran,

Steigmiller

et al. 2024

Diagnostics

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Background: The levator ani muscle (LAM) is crucial for pelvic floor stability, yet its quantitative MRI assessment is only a recent focus. Our study aims to standardize the quantitative analysis of the LAM morphology within the 3D Pelvic Inclination Correction System (3D-PICS). Methods: We analyzed 35 static MR datasets from nulliparous women examining the pubovisceral (PVM), iliococcygeal (ICM), coccygeal (COC), and puborectal muscle (PRM). The PVM consists of three origin-insertion pairs, namely the puboanal (PAM), puboperineal (PPM) and pubovaginal muscle (PVaM). The analysis included a quantitative examination of the morphology of LAM, focusing on the median location (x/y/z) (x: anterior–posterior, y: superior–inferior, z: left–right) of the origin and insertion points (a), angles (b) and lengths (c) of LAM. Inter-rater reliability was calculated. Results: Interindividual variations in 3D coordinates among muscle subdivisions were shown. In all, 93% of all origin and insertion points were found within an SD of <8 mm. Angles to the xz-plane range between −15.4° (right PRM) and 40.7° (left PAM). The PRM is the largest pelvic muscle in static MRI. The ICC indicated moderate-to-good agreement between raters. Conclusions: The accurate morphometry of the LAM and its subdivisions, along with reliable inter-rater agreement, was demonstrated, enhancing the understanding of normal pelvic anatomy in young nulliparous women.

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