Faculty of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing, China.
Department of Gynecology and Obstetrics, First Affiliated Hospital of Army Medical University, Chongqing, China.
J Obstet Gynaecol Res. 2022 Dec;48(12):3269-3278. doi: 10.1111/jog.15440. Epub 2022 Sep 27.
Patients with pelvic organ prolapse (POP) mostly have injury to the levator ani muscle (LAM). We aimed to assess LAM injury in POP patients by quantifying texture feature (TF) ratios between the LAM and the obturator internus muscle (OIM) using texture analysis.
This study retrospectively enrolled 32 participants, including 24 patients with POP and eight people with normal pelvic floor muscles. TFs of the LAM and the OIM were extracted using LIFEx version 6.30, and an independent samples t-test was performed to determine TF ratios characterizing LAM injury. After dimension reduction and binary logic analysis, the optimal TF ratio was obtained and the LAM injury quantitative evaluation was proposed. Spearman's correlation was performed to explore the correlations between TF ratios and clinical characteristics. We compared the diagnostic performance of quantitative evaluation and visual evaluation.
There were significant differences in 13 TF ratios between the POP and control groups. The area under the receiver operating characteristic curve of the integrated TF ratio was 0.948. Integrated TF ratio was significantly correlated with body mass index, pregnancies, and vaginal deliveries but had no correlation with LAM volume, hiatal area or abortions. Compared with the visual evaluation, the diagnostic accuracy of the quantitative evaluation had improved by 63.2% and 14.3% in the "minor defect" and "major defect" categories, respectively.
The integrated TF ratio can be used as a new quantifiable index to characterize LAM injury. The TF evaluation provides a potential role in LAM injury noninvasive diagnostic.
盆腔器官脱垂（POP）患者多存在肛提肌（LAM）损伤。本研究旨在通过对提肛肌和闭孔内肌（OIM）的纹理特征（TF）比值进行定量分析，评估 POP 患者的 LAM 损伤。
本研究回顾性纳入 32 名参与者，包括 24 名 POP 患者和 8 名盆底肌肉正常的人。使用 LIFEx 版本 6.30 提取 LAM 和 OIM 的 TF，并采用独立样本 t 检验确定特征化 LAM 损伤的 TF 比值。经过降维和二进制逻辑分析，获得了最佳 TF 比值，并提出了 LAM 损伤定量评估方法。采用 Spearman 相关分析探讨 TF 比值与临床特征的相关性。比较了定量评估和视觉评估的诊断性能。
POP 组和对照组之间有 13 个 TF 比值存在显著差异。综合 TF 比值的受试者工作特征曲线下面积为 0.948。综合 TF 比值与体重指数、妊娠次数和阴道分娩次数显著相关，但与 LAM 体积、疝孔面积或流产次数无关。与视觉评估相比，定量评估在“轻度缺陷”和“重度缺陷”类别中的诊断准确性分别提高了 63.2%和 14.3%。
综合 TF 比值可作为特征化 LAM 损伤的新的可量化指标。TF 评估在 LAM 损伤的无创诊断中具有潜在作用。
