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Updated: Mar 21, 2026

Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
Published on: April 17, 2019
Feasibility study of transvaginal biplanar convex ultrasound for evaluating levator ani muscle
XinTing Liu1, RuiJie Sun1, NiYa Wei1
1Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, China.
Objective:
To investigate the clinical feasibility and value of transvaginal biplanar convex ultrasound for evaluating the levator ani muscle (LAM).
Methods:
This prospective cross-sectional study enrolled 130 Chinese women undergoing pelvic floor ultrasound examinations. One doctor (operator 1) performed transperineal three-dimensional ultrasound for tomographic ultrasound imaging (TUI) of the LAM. Concurrently, transvaginal biplanar convex ultrasound was used to assess LAM continuity and thickness, measuring the thickness of the attachment and middle portions and the anal canal level. Seven days later, the same doctor (operator 1) and another doctor (operator 2) repeated the LAM thickness measurements. Cohen's kappa coefficient and intraclass correlation coefficients (ICCs) were calculated to analyze the results.
Results:
Transvaginal biplanar convex ultrasound demonstrated excellent consistency with TUI for diagnosing LAM avulsion (Cohen's kappa = 0.74, 95% CI 0.50-0.98). Thickness measurements of each specified segment exhibited excellent intraobserver and good interobserver repeatability (ICC = 0.82-0.86 and 0.74-0.77, respectively). Bland-Altman analysis indicated good consistency between the two operators' measurements.
Conclusions:
Transvaginal biplanar convex ultrasound is a simple, reliable imaging screening method for LAM evaluation.
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