Diagnostic value of three-dimensional ultrasound combined with shear wave elastography for stress urinary incontinence in primiparas
SHEN Xianghui
LI Jie
ZHANG Qiang
LI Meiyan
WU Yulin
NIU Jing
Abstract：Objective To analyze the diagnostic value of three-dimensional ultrasound combined with shear wave elastography(SWE)for stress urinary incontinence(SUI)in primiparas.Methods A total of 112 primiparas who underwent pelvic floor examination at 6-12 weeks after delivery from January 2024 to December 2024 were selected as study subjects.According to the clinical symptoms and urine pad test results,they were divided into SUI group(n=48)and non-SUI group(n=64).All study subjects underwent transperineal pelvic floor ultrasound examination.The area,anteroposterior diameter,left-right diameter of levator hiatus(LHA)in resting state and maximum Valsalva maneuver and thickness of levator ani muscle(LAM)were measured by 3D ultrasound.The mean Young's modulus(Emean)of bilateral puborectalis(PR)in resting state and Valsalva maneuver was measured by SWE technique.The differences in parameters between the two groups were compared.Binary logistic regression analysis was used to analyze the independent risk factors of SUI.ROC curve was used to evaluate the efficiency of each parameter and combined diagnosis of SUI.Results The LHA area,anteroposterior diameter and left-right diameter in resting and Valsalva states in SUI group were larger than those in non-SUI group,and the LAM thickness was thinner than that in non-SUI group(P<0.001).The bilateral PR Emean values in resting and Valsalva states in SUI group were lower than those in non-SUI group(P<0.001).Binary Logistic regression analysis showed that LHA area in Valsalva state(OR=1.402,95%CI:1.150-1.709)and PR Emean in Valsalva state(OR=0.946,95%C I:0.918-0.974)were independent influencing factors of postpartum SUI in primiparas(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of LHA area in Valsalva state was 0.892,and the AUC of PR Emean was 0.875,and the AUC of combined diagnosis was 0.945,with sensitivity of 93.75%and specificity of 81.25%.Conclusion Three-dimensional ultrasound combined with SWE can objectively and quantitatively evaluate the changes of postpartum pelvic floor structure and function in primiparas from two dimensions of morphology and biomechanics.LHA area and PR Emean in Valsalva state are effective indicators for the diagnosis of SUI.The combined detection of the two can significantly enhance the diagnostic efficiency.
Keywords：pelvic floor dysfunctionprimiparasthree-dimensional ultrasoundshear wave elastographystress urinary incontinence
Publication Date：2025-12-20
Online Publishing Date：2026-01-07(First online date of this platform, not the publication date of the document)
Pages：6( 1581-1586 )