Application of Three- and Four-Dimensional Transperineal Ultrasound in Diagnosis of Pelvic Organ Prolapse by Measuring Area of Levator Hiatus

doi:10.12280/gjfckx.20200825

Abstract

Abstract:

Objective: To investigate the value of three- and four-dimensional transperineal ultrasound in diagnosis of pelvic organ prolapse (POP) by measuring levator hiatus area (LHA). Methods: A total of 84 POP patients were collected as the POP group, and 69 cases of healthy women without POP during the same period were selected as the control group. All subjects in both groups were examined by three- and four-dimensional transperineal ultrasound. LHA in resting, maximum Valsalva-3D and maximum Valsalva-4D states were measured and compared, respectively. The difference of LHA in Valsalva-3D and Valsalva-4D was compared within the group. The ROC curves of the rest, Valsalva-3D and Valsalva-4D were drawn to determine the optimal cut-off value of LHA in diagnosis POP, then to evaluate its diagnostic efficacy and compare the differences between the three states. Results: The LHA in resting, Valsalva-3D and Valsalva-4D state in the POP group were larger than those of the control group, and the differences were statistically significant (all P<0.05). There was no significant difference between the LHA of Valsalva-3D and Valsalva-4D state in each group (all P>0.05). The cut-off value of the LHA to diagnose POP was 14.29 cm ², 19.29 cm², 19.90 cm² in resting, Valsalva-3D and Valsalva-4D state, respectively. The areas under the curve (AUC) were 0.759, 0.959, 0.956, respectively. The difference between the AUC of Valsalva-3D and Valsalva-4D and the AUC of resting state was statistically significant (Z=4.980, P<0.01; Z=4.865, P<0.01), and there was no significant difference in AUC between Valsalva-3D and Valsalva-4D state (Z=0.157, P>0.05). Conclusions: The LHA measured by three- and four-dimensional transperineal pelvic floor ultrasound has high diagnostic value for POP, and there was no difference in diagnostic efficiency between the two.

Key words: Ultrasonography, Pelvic floor, Imaging,three-dimensional, Pelvic organ prolapse, Levator hiatus

JIA Hong-jing, DENG Xue-dong, CHEN Xiao-min, CAO Jiao-jiao, MA Lei, LU Bing. Application of Three- and Four-Dimensional Transperineal Ultrasound in Diagnosis of Pelvic Organ Prolapse by Measuring Area of Levator Hiatus[J]. Journal of International Obstetrics and Gynecology, 2021, 48(4): 434-437.

Figures/Tables 6

References 18

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组别	n	静息状态	Valsalva-3D	Valsalva-4D	t′	P′
POP组	84	13.97±2.63	23.79±4.81	23.61±4.79	1.020	0.311
对照组	69	11.62±1.97	15.59±2.48	15.70±2.53	0.888	0.378
t		6.303	13.584	13.064
P		0.000	0.000	0.000

组别	n	静息状态	Valsalva-3D	Valsalva-4D	t′	P′
POP组	84	13.97±2.63	23.79±4.81	23.61±4.79	1.020	0.311
对照组	69	11.62±1.97	15.59±2.48	15.70±2.53	0.888	0.378
t		6.303	13.584	13.064
P		0.000	0.000	0.000

组别	截断值（cm²）	AUC	准确度（%）	敏感度（%）	特异度（%）
静息状态	14.29	0.759	66.67	45.24	92.75
Valsalva-3D	19.29	0.959^a	90.20	85.71	95.65
Valsalva-4D	19.90	0.956^ab	88.24	79.76	98.55

组别	截断值（cm²）	AUC	准确度（%）	敏感度（%）	特异度（%）
静息状态	14.29	0.759	66.67	45.24	92.75
Valsalva-3D	19.29	0.959^a	90.20	85.71	95.65
Valsalva-4D	19.90	0.956^ab	88.24	79.76	98.55