Learning process for performing and analyzing 3D/4D transperineal ultrasound imaging and interobserver reliability...

Area of Science:

• Pelvic floor imaging
• Medical ultrasound technology
• Female pelvic medicine

Background:

• Pelvic floor disorders affect many women.
• Accurate assessment of pelvic floor structures is crucial for diagnosis and treatment.
• Three- and four-dimensional (3D/4D) transperineal ultrasound offers detailed visualization of pelvic floor anatomy.

Purpose of the Study:

• To assess the learning curve for acquiring 3D/4D transperineal ultrasound volumes of the levator hiatus (LH).
• To evaluate the reliability of LH measurements derived from these ultrasound volumes.
• To determine interobserver agreement between experienced and inexperienced examiners.

Main Methods:

• Prospective study of 22 women.
• An inexperienced examiner (IE) learned to acquire and analyze 3D/4D transperineal ultrasound volumes.
• Measurements of LH dimensions were taken at rest, during pelvic floor muscle (PFM) contraction, and Valsalva maneuver.
• Intraclass correlation coefficient (ICC) was used to assess agreement between IE and an experienced examiner (E).

Main Results:

• Good to very good agreement was achieved for most LH measurements after analyzing the first 10 volumes.
• Agreement improved for all LH measurements with subsequent analysis.
• Excellent interobserver reliability (ICC 0.81-0.97) was found for most LH measurements, with good reliability for the pubic arc (ICC = 0.67).

Conclusions:

• 3D/4D transperineal ultrasound is a reliable method for assessing levator hiatus dimensions.
• The technique can be learned effectively in a short period.
• This imaging modality is suitable for evaluating pelvic floor muscle function.