Evidence map›Paper›PMID 40111472›Full record

ArticleInternational urogynecology journal2025

Morphometric Characterization of Levator Ani Subdivisions in Healthy Controls and Patients: An MRI Study Using 3D PICS.

Nina Jessica Gmür, Soleen Ghafoor, Klaus Steigmiller, Thomas Winklehner, Cäcilia S Reiner, Cornelia Betschart

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Article in International urogynecology journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Nina Jessica GmürDepartment of Gynecology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. nina.gmuer@uzh.ch.ORCID 0009-0007-8562-1541
Soleen GhafoorInstitute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.ORCID 0000-0002-8459-7363
Klaus SteigmillerDepartment of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.ORCID 0000-0002-2527-9234
Thomas WinklehnerARTORG, University of Bern, Bern, Switzerland.
Cäcilia S ReinerInstitute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Cornelia BetschartDepartment of Gynecology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.ORCID 0000-0002-0467-0170

Funding

Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (Project Grant 320030_182213
6 · The paper itself

Abstract

introduction and hypothesisTo date, levator ani muscle (LAM) morphometry has been classified descriptively and semi-quantitatively. New MRI techniques enabling detailed visualization with the 3D pelvic inclination correction system (3D PICS) could offer a one-stop-shop diagnostic modality for quantitative assessment of LAM subdivisions. The aim of this controlled MRI study was to assess morphometric LAM subdivision characteristics in two distinct groups of premenopausal women, namely nulliparous asymptomatic controls and symptomatic patients (Pelvic Organ Prolapse Quantification [POP-Q] ≥ II).

methodsMagnetic resonance imaging scans of the 22 women in each group were analyzed applying the 3D PICS coordinate system. A second reading of MRI was used to calculate interrater reliability (IRR). Origins and insertions were expressed in the 3D-Cartesian coordinate system in relation to point 0/0/0 (inferior pubic point). Distances and angles between muscles and planes were described using mean and standard deviation or median with first and third quartiles for all LAM subdivisions.

resultsModerate to good IRR was reported except for points close to point 0/0/0. Origins showed no difference between groups. Insertions differed notably in the vertically oriented pubovaginal, puboperineal, and puboanal muscles, with patients exhibiting lower positions along the superior-inferior axis by 6.1-7.7, 8.8, and 8.0-8.2 mm respectively. In contrast, the insertions of the horizontally oriented puborectal muscle showed a smaller difference of 1.8 mm. Muscle lengths were also 4% to 24% longer in cases.

conclusionsThis in vivo MRI study reveals first geometric 3D data on LAM morphology in 3D PICS for both cases and controls. Exact 3D coordinates of origin/insertion points, lengths, and angles could serve as a basis for future imaging-based POP diagnostics.

Indexed as

Imaging, Three-DimensionalMagnetic Resonance ImagingPelvic FloorPelvic Organ ProlapseAdultCase-Control StudiesFemaleHumansMiddle AgedReproducibility of Results3D pelvic inclination correction system (3D PICS)InsertionMorphometryMRIPelvic floor musclesPelvic organ prolapse

Identifiers

PMID40111472
PMCPMC12287122

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.