Metodología para el estudio ecográfico transperineal del suelo pélvico / Methodology for the transperineal ultrasound imaging of the pelvic floor

Las técnicas de imagen cada vez son más utilizadas dentro de la medicina en general y de la ginecología en particular. La ecografía de suelo pélvico, a diferencia de la aplicación ecográfica en las otras subespecialidades ginecológicas, se encuentra bastante estandarizada y con planos de estudios definidos. Dependiendo del transductor utilizado y del modo de aplicación, se han descrito diferentes métodos ecográficos de valoración del suelo pélvico. De todos estos, el estudio transperineal es el más documentado para el diagnóstico de las disfunciones del suelo pélvico. Por ello, el objetivo de esta revisión es describir el método aplicado para realizar un estudio transperineal 2 D y 3-4D del suelo pélvico, describiendo los planos ecográficos necesarios.(AU)

Imaging techniques are increasingly used within medicine in general, and in gynaecology in particular. Pelvic floor ultrasound, unlike ultrasound application in the other gynaecological subspecialties, is fairly standardised and with defined study plans. Depending on the transducer used, and the mode of application, different ultrasound methods for evaluating the pelvic floor have been described. Of all these methods, the transperineal study is the most documented for the diagnosis of pelvic floor dysfunctions. Therefore, the objective of this review is to describe the method applied to perform a 2 D and 3-4D transperineal study of the pelvic floor, describing the necessary ultrasound planes.(AU)

Online learning for 3D/4D transperineal ultrasound of the pelvic floor.

Introduction. To evaluate the feasibility of an online learning process for performing and analyzing 3D/4D transperineal ultrasound imaging of the pelvic floor.Materials and methods: A prospective study was conducted with 20 patients. The learning process of three inexperienced examiners (IEs) performing and analyzing 3D/4D transperineal ultrasound volumes was evaluated. The learning process for the IEs was conducted online by an expert examiner (EE); no face-to-face tutoring was provided. The IEs' competency and analysis of the volumes were estimated using the intraclass correlation coefficient (ICC).Results: The interobserver analysis of the levator hiatus dimensions provided by the EE and those from each IE (for the 20 studied cases) had ICCs ranging from 0.81 to 0.96. The dimensions of the levator hiatus performed by the IEs for the first 10 patients showed ICCs ranging from 0.55 to 0.9. However, when the IEs proceeded with the next 10 patients, they obtained ICCs ranging from 0.81 to 0.96.Conclusions: Conducting 3D/4D transperineal ultrasound of the pelvic floor is a technique that can be learned online in a short period of time. A learning programme designed specifically for this purpose provides excellent reliability.Key Message: Conducting 3D/4D transperineal ultrasound of the pelvic floor is a technique that can be learned online in a short period of time.