Department of Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, Guangdong Province, China.
Int Urogynecol J. 2024 Jan;35(1):175-181. doi: 10.1007/s00192-023-05686-z. Epub 2023 Nov 29.
Transperineal ultrasound (TPUS) is an effective tool for evaluating the integrity of the levator ani muscle (LAM). Several operating steps are required to obtain the standard multi-slice image of the LAM, which is experience dependent and time consuming. This study was aimed at evaluating the feasibility and reproducibility of the built-in software, Smart-pelvic™, in reconstructing standard tomographic images of LAM from 3D/4D TPUS volumes.
This study was conducted at a tertiary teaching hospital, enrolling women who underwent TPUS. Tomographic images of the LAM were automatically reconstructed by Smart-pelvic and rated by two experienced observers as standard or nonstandard. The anteroposterior diameter (APD) of the levator hiatus was also measured on the mid-sagittal plane of the automatically and manually reconstructed images. The APD measurements of each approach were compared using Bland-Altman plots, and interclass correlation coefficient (ICC) was used to evaluate intra- and inter-observer reproducibility. Meanwhile, the time taken for the reconstruction process of both methods was also recorded.
The ultrasound volume of a total of 104 patients were included in this study. Using Smart-pelvic, the overall success rate of the tomographic image reconstruction was 98%. Regarding measurements of APD, the ICC between the automatic and manual reconstruction methods was 0.99 (0.98, 0.99). The average time taken for reconstruction per case was 2.65 ± 0.52 s and 22.08 ± 3.45 s, respectively.
Using Smart-pelvic to reconstruct tomographic images of LAM is feasible, and it can promote TPUS by reducing operator dependence and improving examination efficiency in a clinical setting.
经会阴超声（TPUS）是评估肛提肌（LAM）完整性的有效工具。获得 LAM 的标准多层图像需要多个操作步骤，这是经验依赖且耗时的。本研究旨在评估内置软件 Smart-pelvic™ 从 3D/4D TPUS 容积中重建 LAM 标准断层图像的可行性和可重复性。
本研究在一家三级教学医院进行，招募了接受 TPUS 的女性。Smart-pelvic 自动重建 LAM 的断层图像，并由两名有经验的观察者对其进行标准或非标准评级。还在自动和手动重建图像的正中矢状面上测量肛提肌裂孔的前后径（APD）。使用 Bland-Altman 图比较两种方法的 APD 测量值，并使用组内相关系数（ICC）评估观察者内和观察者间的可重复性。同时，还记录了两种方法的重建过程所花费的时间。
本研究共纳入 104 名患者的超声容积。使用 Smart-pelvic，断层图像重建的总体成功率为 98%。关于 APD 的测量值，自动和手动重建方法之间的 ICC 为 0.99（0.98，0.99）。重建每个病例的平均时间分别为 2.65 ± 0.52 s 和 22.08 ± 3.45 s。
使用 Smart-pelvic 重建 LAM 的断层图像是可行的，它可以通过减少操作人员的依赖性和提高临床检查效率来促进 TPUS。
