Department of Ultrasound, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China.
Neurourol Urodyn. 2023 Sep;42(7):1547-1554. doi: 10.1002/nau.25231. Epub 2023 Jun 26.
To evaluate the concordance between an automatic software program and manual evaluation in reconstructing, delineating, and measuring the levator hiatus (LH) on maximal Valsalva maneuver.
This was a retrospective study analyzing archived raw ultrasound imaging data of 100 patients underwent transperineal ultrasound (TPUS) examination. Each data were assessed by the automatic Smart Pelvic System software program and manual evaluation. The Dice similarity index (DSI), mean absolute distance (MAD), and Hausdorff distance (HDD) were calculated to quantify delineation accuracy of LH. Agreement between automatic and manual measurement of levator hiatus area was assessed by intraclass correlation coefficient (ICC) and Bland-Altman method.
The satisfaction rate of automatic reconstruction was 94%. Six images were recognized as unsatisfactory reconstructed images for some gas in the rectum and anal canal. Compared with satisfactory reconstructed images, DSI of unsatisfactory reconstructed images was lower, MAD and HDD were larger (p = 0.001, p = 0.001, p = 0.006, respectively). The ICC was up to 0.987 in 94 satisfactory reconstructed images.
The Smart Pelvic System software program had good performance in reconstruction, delineation, and measurement of LH on maximal Valsalva maneuver in clinical practice, despite misidentification of the border of posterior aspect of LH due to the influence of gas in the rectum.
评估自动软件程序与手动评估在重建、描绘和测量最大瓦氏动作时提肛肌裂孔（LH）方面的一致性。
这是一项回顾性研究，分析了 100 名接受经会阴超声（TPUS）检查的患者的存档原始超声成像数据。每个数据均由自动 Smart Pelvic System 软件程序和手动评估进行评估。计算 Dice 相似性指数（DSI）、平均绝对距离（MAD）和 Hausdorff 距离（HDD）来量化 LH 描绘的准确性。通过组内相关系数（ICC）和 Bland-Altman 方法评估自动和手动测量提肛肌裂孔面积的一致性。
自动重建的满意度率为 94%。由于直肠和肛管内有一些气体，有 6 个图像被认为是重建不满意的图像。与满意的重建图像相比，不满意的重建图像的 DSI 较低，MAD 和 HDD 较大（p=0.001，p=0.001，p=0.006，分别）。在 94 个满意的重建图像中，ICC 高达 0.987。
尽管直肠内气体的影响导致 LH 后表面边界的误识别，但 Smart Pelvic System 软件程序在临床实践中在最大瓦氏动作时 LH 的重建、描绘和测量方面表现良好。
