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ECR 2018 / C-0529
Is MRI the gold standard imaging technique to diagnose levator ani muscle avulsion?
Congress: ECR 2018
Poster No.: C-0529
Type: Scientific Exhibit
Keywords: Genital / Reproductive system female, Anatomy, Obstetrics (Pregnancy / birth / postnatal period), MR, Ultrasound, Computer Applications-3D, Imaging sequences, Obstetrics, Pelvic floor dysfunction
Authors: I. van Gruting1, A. Stankiewicz2, A. Sultan1, R. Thakar1; 1London/UK, 2Lublin/PL

Methods and materials


We performed a cross-sectional study on 135 women four years after their first delivery, who were previously recruited as part of a prospective longitudinal study. Symptoms were assessed with the validated International Consultation on Incontinence Questionnaires. Pelvic floor muscle strength (PFMS) was assessed with the Modified Oxford Score (MOS) and pelvic organ prolapse with the validated ICS-POP-Q.

All patients underwent 3D/4D Transperineal US (with the use of convex probe 4-8.5 MHz, Voluson, GE), (Fig.) high frequency 3D Endovaginal US (with the use of rotational 360° automatic acquisition transducer.  6-12MHz, type 8838, BK Medical) (Fig.) and MRI (1.5 Tesla , Siemens). Images were acquired at rest and analysed blinded to clinical and other imaging findings. The LAM was assessed in the plane of minimal hiatal dimensions using the validated DeLancey score9 (Fig) and confirmed in the sagittal plane on MRI and EVUS.

Diagnostic test characteristics were calculated using MRI as the reference standard. Correlation of LAM avulsion with signs and symptoms were assessed with the Chi2, Fisher’s exact and Mann-Whitney U test.


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