In vivo assessment of the levator ani muscles using shear wave elastography: a feasibility study in women

• DOI: 10.1007/s00192-018-3693-4
• Publication Date: 2018-06-30T01:18:37Z
• Authors: Bertrand Gachon; Antoine Nordez; Fabrice Pierre; Laetitia Fradet; Xavier Fritel; David Desseauve
• Keywords: Adult; Valsalva Maneuver; [PHYS.MPHY]Physics [physics]/Mathematical Physics [math-ph]; 610; Pelvic floor; [SPI.AUTO]Engineering Sciences [physics]/Automatic; 03 medical and health sciences; 0302 clinical medicine; [PHYS.QPHY]Physics [physics]/Quantum Physics [quant-ph]; Humans; Biomechanics; Women; [PHYS.MECA.MEFL]Physics [physics]/Mechanics [physics]/Fluid mechanics [physics.class-ph]; Longitudinal Studies; Prospective Studies; [PHYS.MECA.BIOM]Physics [physics]/Mechanics [physics]/Biomechanics [physics.med-ph]; Levator ani muscle; [SPI.ACOU]Engineering Sciences [physics]/Acoustics [physics.class-ph]; [PHYS.MECA.VIBR]Physics [physics]/Mechanics [physics]/Vibrations [physics.class-ph]; [SPI.FLUID]Engineering Sciences [physics]/Reactive fluid environment; [SPI.NRJ]Engineering Sciences [physics]/Electric power; 600; [CHIM.MATE]Chemical Sciences/Material chemistry; Pelvic Floor; [PHYS.MECA.MSMECA]Physics [physics]/Mechanics [physics]/Materials and structures in mechanics [physics.class-ph]; 16. Peace & justice; Elasticity; Shear wave; [PHYS.MECA.ACOU]Physics [physics]/Mechanics [physics]/Acoustics [physics.class-ph]; [SPI.ELEC]Engineering Sciences [physics]/Electromagnetism; [CHIM.POLY]Chemical Sciences/Polymers; [PHYS.MECA.THER]Physics [physics]/Mechanics [physics]/Thermics [physics.class-ph]; Elasticity Imaging Techniques; Feasibility Studies; Female; Elastography

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-2. 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.