Fig 1.
Multiplanar mode depicting three orthogonal planes of normal levator ani (LA) insertion: midsagittal plane (top left); coronal plane (top right); and axial plane (bottom left). Determination of the minimal axial plan according to anteroposterior diameter (double-sided arrow) in the midsagittal plane (top left). Image of the intact crescent-shape LA muscles (white arrows) in the coronal plane (top left). P: symphysis pubis.
Fig 2.
Left image depicts an intact levator ani (LA) muscle on right side (short white arrows) and a left-sided avulsion in coronal plane (long white arrows), and the measurement of the levator ani muscle injury (LAMI) depth (long white arrows) above the minimal axial plane in the coronal plane (reference line is the white horizontal line).
Right image depicts levator avulsion on the left side in slices 3–8 on tomographic ultrasound imaging (TUI). TUI score of the right side is 0 and 6 on the left side. P: symphysis pubis.
Table 1.
Discrepancies in determining an avulsion between the multiplanar mode and tomographic ultrasound imaging (TUI) (n = 135).
Fig 3.
Receiver operating characteristic curve analysis demonstrating cut-offs at 7 mm for levator ani muscle injury (LAMI) depth against International Continence Society pelvic organ prolapse (POP) quantification (ICS POP-Q) stage 2 or higher (A), and prolapse symptoms (B).
Fig 4.
Receiver operating characteristic curve analysis demonstrating cut-offs at 7 mm for levator ani muscle injury (LAMI) depth according to significant pelvic organ prolapse on translabial ultrasonography (TLUS) (A) and hiatal ballooning (B).