title: Can 3D power Doppler identify levator ani vascularization at its pubic insertion?
abstract: OBJECTIVE
  The levator ani is the most important muscle in the pelvic floor. This pilot study using 3D power Doppler aimed to identify normal vascularization of the puborectalis/pubovisceralis muscle at its insertion in nulliparous and premenopausal women.
  
  
  METHODS
  Forty nulliparous and premenopausal women were evaluated at the Gynecological Unit of a tertiary hospital. All women underwent a translabial ultrasound (US) with 3D power Doppler. Pubic insertion of the puborectalis/pubovisceralis muscle was assessed in the axial plane, and vascularization index (VI), flow index (FI), and vascularization-flow index (VFI) were calculated bilaterally. Volumes were analyzed offline by two independent observers, and interobserver agreement and correlation between variables was calculated.
  
  
  RESULTS
  A high, statistically significant, correlation was found between the three US indices on each side (p < 0.005). No correlation was found between the US index and either of the demographic parameters of body mass index [(BMI), p > 0.241], or age (p > 0.398). The degree of correlation between the same index on the different sides was not statistically significant.
  
  
  CONCLUSIONS
  Puborectalis/pubovisceralis muscle vascularization at its insertion can be identified using 3D Doppler US, but values differ substantially from those of the contralateral side.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Mútua Terrassa, Plaça Doctor Robert, 5, Terrassa, 08221, Spain, jcassado@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Cassadó Garriga
authors.forename: L
authors.initials: L
authors.lastname: Quintas Marques
authors.forename: A
authors.initials: A
authors.lastname: Pessarrodona Isern
authors.forename: E
authors.initials: E
authors.lastname: López Quesada
authors.forename: M
authors.initials: M
authors.lastname: Rodriguez Carballeira
authors.forename: A
authors.initials: A
authors.lastname: Badia Carrasco
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D010298:Parity; D017773:Pelvic Floor / Q000098:blood supply / Q000000981:diagnostic imaging*; D010865:Pilot Projects; D017697:Premenopause; D012016:Reference Values; D015203:Reproducibility of Results; D018608:Ultrasonography, Doppler
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