Gachon Bertrand, Nordez Antoine, Pierre Fabrice, Fradet Laetitia, Fritel Xavier, Desseauve David
Department of Obstetrics and Gynecology, La Miletrie University Hospital, 2 rue de la Miletrie CS90577, 86021, Poitiers Cedex, France.
Laboratory "Movement, Interactions, Performance" (EA 4334), Faculty of Sport Sciences, University of Nantes, Nantes, France.
Int Urogynecol J. 2019 Jul;30(7):1179-1186. doi: 10.1007/s00192-018-3693-4. Epub 2018 Jun 30.
We hypothesized that shear wave elastography (SWE) technology might be useful for assessing the elastic properties of the pelvic floor in women. Our primary objective was to evaluate the feasibility of assessing the levator ani muscles using SWE in women. Our secondary aim was to investigate the changes in their elastic properties from rest to Valsalva maneuver.
During this prospective feasibility study in nonpregnant female volunteers, we collected data on participant age, body mass index (BMI), parity, and time since the delivery. The levator ani muscles of each participant were assessed using SWE technology at rest and during a Valsalva maneuver by measuring the shear modulus (in kilopascals). We then assessed the changes in the shear modulus at rest and during the Valsalva maneuver using a Wilcoxon test.
Twelve parous women participated in this study. The mean time since the last delivery was 14 months, the mean age was 31 years, and mean BMI was 28 kg.m. All the assessments performed at rest were successfully completed, but we encountered two failures during the Valsalva maneuver. The mean shear modulus increased by a factor of more than 2 from rest to the Valsalva maneuver for both the right (16.0 vs 35.4 kPa) and left side (17.1 vs 37.6 kPa).
An assessment of the elastic properties of the levator ani muscles is feasible for nonpregnant women. The reproducibility of the technique and its application in pregnant women and women with pelvic floor disorders must be investigated.
我们假设剪切波弹性成像（SWE）技术可能有助于评估女性盆底的弹性特性。我们的主要目标是评估在女性中使用SWE评估肛提肌的可行性。我们的次要目标是研究从静息状态到瓦尔萨尔瓦动作期间其弹性特性的变化。
在这项针对非孕女性志愿者的前瞻性可行性研究中，我们收集了参与者的年龄、体重指数（BMI）、产次和分娩后的时间数据。通过测量剪切模量（以千帕为单位），在静息状态和瓦尔萨尔瓦动作期间使用SWE技术对每位参与者的肛提肌进行评估。然后，我们使用Wilcoxon检验评估静息状态和瓦尔萨尔瓦动作期间剪切模量的变化。
12名经产妇参与了本研究。距上次分娩的平均时间为14个月，平均年龄为31岁，平均BMI为28kg/m²。所有在静息状态下进行的评估均成功完成，但在瓦尔萨尔瓦动作期间我们遇到了两次失败。从静息状态到瓦尔萨尔瓦动作，右侧（16.0对35.4kPa）和左侧（17.1对37.6kPa）的平均剪切模量均增加了2倍以上。
对非孕女性评估肛提肌的弹性特性是可行的。必须研究该技术的可重复性及其在孕妇和盆底功能障碍女性中的应用。
