Articles Tập 67 Số CĐ9-Hội Y học Giới tính 26/08/2026

PELVIC FLOOR ULTRASOUND IN THE EVALUATION OF PELVIC ORGAN PROLAPSE IN WOMEN: A COMPARATIVE STUDY WITH DYNAMIC MRI

Do Hong Hanh1,2, Do Tat Thanh1,2,3,4, Hoang Dinh Au1,2,5,6, Tran Ngoc Dung1,2,5,6
1 Hanoi Medical University
2 Trường Đại học Y Hà Nội
3 Viet Duc University Hospital
4 Bệnh viện Hữu Nghị Việt Đức
5 Hanoi Medical University Hospital
6 Bệnh viện Đại học Y Hà Nội
DOI: 10.52163/yhc.v67iCD9.6383
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Keywords
Pelvic organ prolapse; transperineal ultrasound; pelvic floor MRI; levator hiatus.
Abstract

Objective: To evaluate the value of transperineal ultrasound (TPUS) in assessing pelvic organ prolapse (POP) in women, using dynamic pelvic floor magnetic resonance imaging (MRI) as a reference. Methods: A cross-sectional study was conducted on 10 female patients with suspected or confirmed Pelvic Organ Prolapse (POP) at Hanoi Medical University Hospital (August 2025–March 2026). Assessed parameters included bladder, uterine, and rectal descent, as well as levator hiatus measurements (anteroposterior diameter, transverse diameter, and area) at rest and during dynamic maneuvers. Correlation and agreement between transperineal ultrasound and MRI were evaluated using Pearson correlation, intraclass correlation coefficient (ICC), and Bland–Altman analysis. Results: At rest, strong correlations were observed between transperineal ultrasound and MRI (r = 0.94–0.98; p < 0.001), with small mean differences and high ICC values (0.94–0.96). Under dynamic conditions, correlations decreased but remained statistically significant (r = 0.66–0.90; p < 0.05), with lower ICC values (0.49–0.84). Negative mean bias at dynamic phases indicated that transperineal ultrasound tended to underestimate the degree of prolapse compared to MRI. Conclusion: Transperineal ultrasound demonstrates good correlation and agreement with MRI in the assessment of POP, particularly at rest. It may serve as a useful initial imaging modality in clinical practice; however, further studies with larger sample sizes are required to validate these findings.

References
[1]
Doshani A, Teo REC, Mayne CJ, Tincello DG. Uterine prolapse. BMJ. 2007 Oct 20;335(7624):819–23. doi:10.1136/bmj.39356.604074.BE PubMed PMID: 17947787; PubMed Central PMCID: PMC2034734. Google Scholar
[2]
EL-Gharib M. Central and Lateral Cystocele. Sci J Res Rev. 2018 Dec 14;1:1–3. doi:10.33552/SJRR.2018.01.000505 Google Scholar
[3]
Đức VT. ĐÁNH GIÁ ĐẶC ĐIỂM SA TRỰC TRÀNG KIỂU TÚI Ở BỆNH NHÂN RỐI LOẠN CHỨC NĂNG SÀN CHẬU BẰNG CỘNG HƯỞNG TỪ ĐỘNG. Tạp Chí Điện Quang Học Hạt Nhân Việt Nam. 2022 Jul 11;(15):19–25. doi:10.55046/vjrnm.15.340.2014 Google Scholar
[4]
Majida M, BrÆkken IH, Bø K, Benth JŠ, Engh ME. Validation of three-dimensional perineal ultrasound and magnetic resonance imaging measurements of the pubovisceral muscle at rest. Ultrasound Obstet Gynecol. 2010 Jun 1;35(6):715–22. doi:10.1002/uog.7587 Google Scholar
[5]
Dietz HP. Pelvic Floor Ultrasound: Basic Physics, Instrumentation, and Examination Technique. In: Dietz HP, Hoyte LPJ, Steensma AB, editors. Atlas of Pelvic Floor Ultrasound [Internet]. London: Springer; 2008 [cited 2026 Apr 12]. p. 23–9. Available from: https://doi.org/10.1007/978-1-84628-584-4_2 doi:10.1007/978-1-84628-584-4_2 Google Scholar
[6]
El-Gohary T, Hamed ST, El-Azizi HM, Haggag HM, Azzam H. The role of pelvic floor ultrasound correlated with pelvic organ prolapse quantification in the assessment of anterior and apical compartments of pelvic organ prolapse. Egypt J Radiol Nucl Med. 2024 Mar 29;55(1):68. doi:10.1186/s43055-024-01235-w Google Scholar
[7]
Dietz HP, Shek C. Levator avulsion and grading of pelvic floor muscle strength. Int Urogynecology J. 2008 May 1;19(5):633–6. doi:10.1007/s00192-007-0491-9 Google Scholar
[8]
Dietz HP. Pelvic floor ultrasound: a review. Am J Obstet Gynecol. 2010 Apr;202(4):321–34. doi:10.1016/j.ajog.2009.08.018 PubMed PMID: 20350640. Google Scholar
[9]
Barakat B, Afzal A, Schweda D, Laali A. Comparison of magnetic resonance defecography with pelvic floor ultrasound and vaginal inspection in the urogynecological diagnosis of pelvic floor dysfunction. Urol Ann. 2020;12(2):150. doi:10.4103/UA.UA_78_19 Google Scholar
[10]
Barakat B, Afzal A, Schweda D, Laali A. Comparison of magnetic resonance defecography with pelvic floor ultrasound and vaginal inspection in the urogynecological diagnosis of pelvic floor dysfunction. Urol Ann. 2020 Jun;12(2):150. doi:10.4103/UA.UA_78_19 Google Scholar
[11]
Chamié LP, Ribeiro DMFR, Caiado AH, Warmbrand G, Serafini PC. Translabial US and Dynamic MR Imaging of the Pelvic Floor: Normal Anatomy and Dysfunction. RadioGraphics. 2018 Jan;38(1):287–308. doi:10.1148/rg.2018170055 Google Scholar
[12]
Xuan Y, Friedman T, Dietz HP. Does levator ani hiatal area configuration affect pelvic organ prolapse? Ultrasound Obstet Gynecol. 2019 Jul;54(1):124–7. doi:10.1002/uog.20210 Google Scholar