title: Comparison of translabial three-dimensional ultrasound with magnetic resonance imaging for measurement of levator hiatal biometry at rest.
abstract: OBJECTIVE
  To compare translabial three-dimensional (3D) ultrasound with magnetic resonance imaging (MRI) for the measurement of levator hiatal biometry at rest in women with pelvic organ prolapse, and to determine the interobserver reliability between two independent observers for ultrasound and MRI measurements.
  
  
  METHODS
  Data were derived from a multicenter prospective cohort study in which women scheduled for conventional anterior colporrhaphy underwent translabial 3D ultrasound and MRI prior to surgery. Intraclass correlation coefficients (ICCs) were calculated to estimate interobserver reliability between two independent observers and determine the agreement between ultrasound and MRI measurements. Bland-Altman plots were created to assess the agreement between ultrasound and MRI measurements.
  
  
  RESULTS
  Data from 139 women from nine hospitals were included in the study. The interobserver reliability of ultrasound assessment at rest, during Valsalva maneuver and during contraction and of MRI assessment at rest were moderate or good. The agreement between ultrasound and MRI for the measurement of levator hiatal biometry at rest was moderate, with ICCs of 0.52 (95%CI, 0.32-0.66) for levator hiatal area, 0.44 (95%CI, 0.21-0.60) for anteroposterior diameter and 0.44 (95%CI, 0.22-0.60) for transverse diameter. Levator hiatal biometry measurements were statistically significantly larger on MRI than on translabial 3D ultrasound.
  
  
  CONCLUSIONS
  The agreement between translabial 3D ultrasound and MRI for measurement of the levator hiatus at rest in women with pelvic organ prolapse was only moderate. The results of translabial 3D ultrasound and MRI should therefore not be used interchangeably in daily practice or in clinical research. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
authors.affiliation: Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: T F M
authors.initials: TF
authors.lastname: Vergeldt
authors.affiliation: Department of Obstetrics and Gynaecology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: K J B
authors.initials: KJ
authors.lastname: Notten
authors.affiliation: Department of Radiology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Stoker
authors.affiliation: Department of Radiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: J J
authors.initials: JJ
authors.lastname: Fütterer
authors.affiliation: Department of Radiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: R G
authors.initials: RG
authors.lastname: Beets-Tan
authors.affiliation: Department of Radiology, Atrium Medical Centre Parkstad, Heerlen, The Netherlands.
authors.forename: R F A
authors.initials: RF
authors.lastname: Vliegen
authors.affiliation: Department of Obstetrics and Gynaecology, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: K J
authors.initials: KJ
authors.lastname: Schweitzer
authors.affiliation: Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: F E M
authors.initials: FE
authors.lastname: Mulder
authors.affiliation: Department of Epidemiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: S M J
authors.initials: SM
authors.lastname: van Kuijk
authors.affiliation: Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: J P W R
authors.initials: JP
authors.lastname: Roovers
authors.affiliation: Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: K B
authors.initials: KB
authors.lastname: Kluivers
authors.affiliation: Department of Obstetrics and Gynaecology, Atrium Medical Centre Parkstad, Heerlen, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Weemhoff
mesh_terms: D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009119:Muscle Contraction; D015588:Observer Variation; D017773:Pelvic Floor / Q000000981:diagnostic imaging*; D056887:Pelvic Organ Prolapse / Q000000981:diagnostic imaging; D011247:Pregnancy; D011446:Prospective Studies; D015203:Reproducibility of Results; D014463:Ultrasonography / Q000379:methods*; D014636:Valsalva Maneuver / Q000502:physiology*
keywords: biometry; imaging; levator hiatus; magnetic resonance imaging; pelvic floor; ultrasound