RESUMO
OBJECTIVE: Delivery-related levator avulsion can cause pelvic floor dysfunction. We compared agreement between tomographic ultrasound and magnetic resonance-based models for the detection of levator defects. STUDY DESIGN: Sixty-nine Chinese women with pelvic organ prolapse were assessed prospectively by 3-dimensional ultrasound scans and magnetic resonance imaging. Levator-urethra gap (LUG), levator-symphysis gap (LSG), and puborectalis attachment width were measured offline with state-of-the-art software. Interobserver variability and agreement between the 2 methods were determined. RESULTS: Interobserver repeatability was moderate-to-excellent for all parameters that were measured with both methods and agreement between methods in diagnosing levator avulsion. LUG and LSG measurements were significantly higher in women with a levator avulsion. With a diagnosis of complete levator avulsion, receiver operating characteristics analysis suggested a cutoff of 23.65 mm for LUG and 28.7 mm for LSG. CONCLUSION: Levator avulsion can be diagnosed reliably by tomographic ultrasound scanning and magnetic resonance imaging evaluation, and linear measures, such as LSG and LUG, can be proxy measurements for avulsion.