Dimitrov R
Akush Ginekol (Sofiia). 2013;52(2):3-8.
Images of the levator hiatus in 40 nulliparous, 40 asymptomatic parous women and 40 women with pelvic organ prolapse were obtained by transperineal/translabial three-dimentional ultrasonography of the pelvic floor. Volumes were taken at rest and during squeezing. Recontructed images of the levator hiatus at the plane of minimal dimentions were obtained by off-line processing of the stored volumes. The transverse, the longitudinal diameter and the area of the levator hiatus were measured at rest and during squeezing in the three groups. Qualitative assessment of the shape and the symmetry of the levator hiatus at rest was made, too. The average hiatal dimentions (transverse, longitudinal diameter and hiatal area) measured at rest in the three groups were: 35.8 mm, 43.1 mm and 11.84 cm2 in the nulliparous; 43.6 mm, 47.1 mm and 15.1 cm2 in the asymptomatic parous women and 50.5 mm, 57.2 mm and 25.8 cm2 in women with pelvic organ prolapse. Nulliparous women achieved the greatest reduction of hiatal area during squeezing (by 21% average). In asymptomatic parous women the hiatal area reduction averaged 12% while in women with pelvic organ prolapse the average reduction was by 4% only. Levator injury was detected in 7.5% of the asymptomatic parous women and in 22.5% of the women with pelvic organ prolapse. Left-sided injuries predominated. Three-dimentional ultrasound provides easy and high-quality imaging of the pubovisceral miscles for the objective assessment of the levator hiatus in static and dynamic conditions.
通过经会阴/经阴唇盆底三维超声检查，获取了40名未生育女性、40名无症状经产妇和40名盆腔器官脱垂女性的肛提肌裂孔图像。在静息状态和挤压时采集容积数据。通过对存储容积进行离线处理，获得了肛提肌裂孔最小平面的重建图像。测量了三组在静息状态和挤压时肛提肌裂孔的横径、纵径和面积。还对静息状态下肛提肌裂孔的形状和对称性进行了定性评估。三组静息状态下测量的平均裂孔尺寸（横径、纵径和裂孔面积）分别为：未生育女性35.8毫米、43.1毫米和11.84平方厘米；无症状经产妇43.6毫米、47.1毫米和15.1平方厘米；盆腔器官脱垂女性50.5毫米、57.2毫米和25.8平方厘米。未生育女性在挤压时裂孔面积缩小最大（平均缩小21%）。无症状经产妇裂孔面积平均缩小12%，而盆腔器官脱垂女性平均缩小仅4%。在7.5%的无症状经产妇和22.5%的盆腔器官脱垂女性中检测到肛提肌损伤。左侧损伤占主导。三维超声可为耻骨内脏肌提供简便且高质量的成像，用于在静态和动态条件下客观评估肛提肌裂孔。
