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C H Van Der Vaart - One of the best experts on this subject based on the ideXlab platform.
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Echogenicity of puborectalis muscle cervix and vastus lateralis muscle in pregnancy in relation to mode of delivery
Ultrasound in Obstetrics & Gynecology, 2019Co-Authors: M K Van De Waarsenburg, Mariella I J Withagen, F Van Den Noort, J Schagen H Van Leeuwen, C H Van Der VaartAbstract:Objectives: To confirm our previous observation that levator hiatal dimensions and mean Echogenicity of the puborectalis muscle (MEP) are significantly different at 12 weeks' gestation in women who delivered by Cesarean section due to failure to progress compared with those who delivered vaginally. The secondary objective was to assess the association between the Echogenicity of the cervix and vastus lateralis muscle and mode of delivery. Methods: In this prospective multicenter study, 306 nulliparous women with a singleton pregnancy underwent ultrasound assessments of the pelvic floor at rest, on maximum pelvic floor muscle contraction and on maximum Valsalva maneuver, of the cervix and of the vastus lateralis muscle at 12 weeks' gestation. Dimensions of the levator hiatus, MEP and mean Echogenicity of the cervix and vastus lateralis muscle were measured and compared according to mode of delivery. Results: Two hundred and forty-nine women were included in the analyses. We were unable to confirm our previous finding that MEP and levator hiatal transverse diameter and area at 12 weeks' gestation are associated significantly with mode of delivery. In addition, we could not demonstrate a significant association between Echogenicity of the cervix or vastus lateralis muscle and mode of delivery. Overall, MEP was a mean of 20 points lower in women in the new database as compared with the previous study, despite the use of the same ultrasound equipment. Conclusion: In a second, independent multicenter dataset, we were unable to confirm our previous finding that levator hiatal dimensions and MEP on pelvic floor muscle contraction are associated significantly with mode of delivery. We also found no association between Echogenicity of the cervix or vastus lateralis and mode of delivery.
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association of first trimester Echogenicity of the puborectalis muscle with mode of delivery
Obstetrics & Gynecology, 2016Co-Authors: Anique T M Grob, M K Van De Waarsenburg, Mariella I J Withagen, Karlijn J Schweitzer, C H Van Der VaartAbstract:OBJECTIVE: To evaluate the association between mean Echogenicity of the puborectalis muscle, measured using transperineal ultrasonography, in women during their first pregnancy and the subsequent mode of delivery. METHODS: This is a secondary analysis of a prospective observational study on the association between stress urinary incontinence and levator muscle avulsion after delivery of a first pregnancy. In this study, 280 nulliparous women with singleton pregnancies were examined with transperineal ultrasound examination at 12 and 36 weeks of gestation. Patients were recruited from an obstetrics practice associated with the university medical center in Utrecht, the Netherlands. Mean Echogenicity of the puborectalis muscle values were measured at rest, in pelvic floor muscle contraction, and during the Valsalva maneuver. The subsequent mode of delivery was classified into five categories: spontaneous vaginal delivery, instrumental vaginal delivery, elective cesarean delivery, cesarean delivery resulting from nonreassuring fetal status, and cesarean delivery resulting from failure to progress. Mean Echogenicity of the puborectalis muscle values according to mode of delivery were compared by analysis of variance and Tukey's post hoc test. RESULTS: Of the 254 women included, 157 had spontaneous vaginal delivery, 47 underwent cesarean delivery (11 elective, 36 emergency), and 45 had vacuum operative vaginal delivery; in five patient files, the mode of delivery was not recorded. Of the analyzed women, those who delivered by cesarean because of failure to progress had a significantly lower mean Echogenicity of the puborectalis muscle in pelvic floor contraction at 12 weeks of gestation (mean Echogenicity of 116±14) than women who had spontaneous vaginal delivery (132±21; Tukey's post hoc test, P=.03), instrumental vaginal delivery (138±21; P=.004), and cesarean delivery resulting from nonreassuring fetal status (139±20; P=.02). CONCLUSION: Lower mean Echogenicity of the puborectalis muscle values in pelvic floor contraction during the first pregnancy at 12 weeks of gestation is associated with subsequent cesarean delivery as a result of failure to progress.
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changes in the mean Echogenicity and area of the puborectalis muscle during pregnancy and postpartum
International Urogynecology Journal, 2016Co-Authors: Anique T M Grob, M K Van De Waarsenburg, Mariella I J Withagen, Karlijn J Schweitzer, C H Van Der VaartAbstract:Introduction and hypothesis Three-dimensional (3D) and four-dimensional (4D) volume transperineal ultrasound imaging is increasingly used to assess changes in the dimensions of the pelvic floor during pregnancy and after delivery. Little is known with regard to the area of the puborectalis muscle and its structural changes. Echogenicity measurement, a parameter that provides information on the structure of muscles, is increasingly used in orthopaedics and neuromuscular disease evaluation. This study is aimed at assessing the changes in the mean Echogenicity of the puborectalis muscle (MEP) and the puborectalis muscle area (PMA) during first pregnancy and after childbirth.
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measuring Echogenicity and area of the puborectalis muscle method and reliability
Ultrasound in Obstetrics & Gynecology, 2014Co-Authors: Anique T M Grob, Mariella I J Withagen, Karlijn J Schweitzer, A Veen, Greetje A Van Veelen, C H Van Der VaartAbstract:OBJECTIVES: To develop a semi-automated method to assess puborectalis muscle Echogenicity on three-dimensional/four-dimensional (3D/4D) volume transperineal ultrasound images using 4D View and Matlab® software and evaluate its intra- and interobserver reliability. METHOD: The data of 23 women in their first trimester were included. 3D/4D volume datasets were obtained at rest. Two inexperienced observers were trained by an experienced observer to construct tomographic ultrasound images (TUI) from the original data and to delineate all structures. Puborectalis muscle area (PMA) and the mean Echogenicity of the puborectalis muscle (MEP) were calculated offline. Intra- and interobserver reliability were determined by intraclass correlation coefficients (ICC) and their 95% CIs. RESULTS: The development of a semi-automated method to calculate puborectalis area and Echogenicity is described in detail. PMA and MEP measurements in pregnant women demonstrated almost perfect intraobserver reliability for both inexperienced observers, with ICC values ranging from 0.88 to 0.99. The interobserver reliability showed ICCs of 0.63 for PMA and almost perfect ICC values, of 0.96-0.98, for Echogenicity. The majority of intraobserver mismatch between two delineations of PMA occurred near the borders. CONCLUSIONS: Matlab software can be used to provide reliable measurements of the area and Echogenicity of the puborectalis muscle. As the latter can be used to assess structural changes in the puborectalis muscle, it appears a promising new tool for studying pelvic floor structural anatomy.
Anique T M Grob - One of the best experts on this subject based on the ideXlab platform.
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association of first trimester Echogenicity of the puborectalis muscle with mode of delivery
Obstetrics & Gynecology, 2016Co-Authors: Anique T M Grob, M K Van De Waarsenburg, Mariella I J Withagen, Karlijn J Schweitzer, C H Van Der VaartAbstract:OBJECTIVE: To evaluate the association between mean Echogenicity of the puborectalis muscle, measured using transperineal ultrasonography, in women during their first pregnancy and the subsequent mode of delivery. METHODS: This is a secondary analysis of a prospective observational study on the association between stress urinary incontinence and levator muscle avulsion after delivery of a first pregnancy. In this study, 280 nulliparous women with singleton pregnancies were examined with transperineal ultrasound examination at 12 and 36 weeks of gestation. Patients were recruited from an obstetrics practice associated with the university medical center in Utrecht, the Netherlands. Mean Echogenicity of the puborectalis muscle values were measured at rest, in pelvic floor muscle contraction, and during the Valsalva maneuver. The subsequent mode of delivery was classified into five categories: spontaneous vaginal delivery, instrumental vaginal delivery, elective cesarean delivery, cesarean delivery resulting from nonreassuring fetal status, and cesarean delivery resulting from failure to progress. Mean Echogenicity of the puborectalis muscle values according to mode of delivery were compared by analysis of variance and Tukey's post hoc test. RESULTS: Of the 254 women included, 157 had spontaneous vaginal delivery, 47 underwent cesarean delivery (11 elective, 36 emergency), and 45 had vacuum operative vaginal delivery; in five patient files, the mode of delivery was not recorded. Of the analyzed women, those who delivered by cesarean because of failure to progress had a significantly lower mean Echogenicity of the puborectalis muscle in pelvic floor contraction at 12 weeks of gestation (mean Echogenicity of 116±14) than women who had spontaneous vaginal delivery (132±21; Tukey's post hoc test, P=.03), instrumental vaginal delivery (138±21; P=.004), and cesarean delivery resulting from nonreassuring fetal status (139±20; P=.02). CONCLUSION: Lower mean Echogenicity of the puborectalis muscle values in pelvic floor contraction during the first pregnancy at 12 weeks of gestation is associated with subsequent cesarean delivery as a result of failure to progress.
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changes in the mean Echogenicity and area of the puborectalis muscle during pregnancy and postpartum
International Urogynecology Journal, 2016Co-Authors: Anique T M Grob, M K Van De Waarsenburg, Mariella I J Withagen, Karlijn J Schweitzer, C H Van Der VaartAbstract:Introduction and hypothesis Three-dimensional (3D) and four-dimensional (4D) volume transperineal ultrasound imaging is increasingly used to assess changes in the dimensions of the pelvic floor during pregnancy and after delivery. Little is known with regard to the area of the puborectalis muscle and its structural changes. Echogenicity measurement, a parameter that provides information on the structure of muscles, is increasingly used in orthopaedics and neuromuscular disease evaluation. This study is aimed at assessing the changes in the mean Echogenicity of the puborectalis muscle (MEP) and the puborectalis muscle area (PMA) during first pregnancy and after childbirth.
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measuring Echogenicity and area of the puborectalis muscle method and reliability
Ultrasound in Obstetrics & Gynecology, 2014Co-Authors: Anique T M Grob, Mariella I J Withagen, Karlijn J Schweitzer, A Veen, Greetje A Van Veelen, C H Van Der VaartAbstract:OBJECTIVES: To develop a semi-automated method to assess puborectalis muscle Echogenicity on three-dimensional/four-dimensional (3D/4D) volume transperineal ultrasound images using 4D View and Matlab® software and evaluate its intra- and interobserver reliability. METHOD: The data of 23 women in their first trimester were included. 3D/4D volume datasets were obtained at rest. Two inexperienced observers were trained by an experienced observer to construct tomographic ultrasound images (TUI) from the original data and to delineate all structures. Puborectalis muscle area (PMA) and the mean Echogenicity of the puborectalis muscle (MEP) were calculated offline. Intra- and interobserver reliability were determined by intraclass correlation coefficients (ICC) and their 95% CIs. RESULTS: The development of a semi-automated method to calculate puborectalis area and Echogenicity is described in detail. PMA and MEP measurements in pregnant women demonstrated almost perfect intraobserver reliability for both inexperienced observers, with ICC values ranging from 0.88 to 0.99. The interobserver reliability showed ICCs of 0.63 for PMA and almost perfect ICC values, of 0.96-0.98, for Echogenicity. The majority of intraobserver mismatch between two delineations of PMA occurred near the borders. CONCLUSIONS: Matlab software can be used to provide reliable measurements of the area and Echogenicity of the puborectalis muscle. As the latter can be used to assess structural changes in the puborectalis muscle, it appears a promising new tool for studying pelvic floor structural anatomy.
Mariella I J Withagen - One of the best experts on this subject based on the ideXlab platform.
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Echogenicity of puborectalis muscle cervix and vastus lateralis muscle in pregnancy in relation to mode of delivery
Ultrasound in Obstetrics & Gynecology, 2019Co-Authors: M K Van De Waarsenburg, Mariella I J Withagen, F Van Den Noort, J Schagen H Van Leeuwen, C H Van Der VaartAbstract:Objectives: To confirm our previous observation that levator hiatal dimensions and mean Echogenicity of the puborectalis muscle (MEP) are significantly different at 12 weeks' gestation in women who delivered by Cesarean section due to failure to progress compared with those who delivered vaginally. The secondary objective was to assess the association between the Echogenicity of the cervix and vastus lateralis muscle and mode of delivery. Methods: In this prospective multicenter study, 306 nulliparous women with a singleton pregnancy underwent ultrasound assessments of the pelvic floor at rest, on maximum pelvic floor muscle contraction and on maximum Valsalva maneuver, of the cervix and of the vastus lateralis muscle at 12 weeks' gestation. Dimensions of the levator hiatus, MEP and mean Echogenicity of the cervix and vastus lateralis muscle were measured and compared according to mode of delivery. Results: Two hundred and forty-nine women were included in the analyses. We were unable to confirm our previous finding that MEP and levator hiatal transverse diameter and area at 12 weeks' gestation are associated significantly with mode of delivery. In addition, we could not demonstrate a significant association between Echogenicity of the cervix or vastus lateralis muscle and mode of delivery. Overall, MEP was a mean of 20 points lower in women in the new database as compared with the previous study, despite the use of the same ultrasound equipment. Conclusion: In a second, independent multicenter dataset, we were unable to confirm our previous finding that levator hiatal dimensions and MEP on pelvic floor muscle contraction are associated significantly with mode of delivery. We also found no association between Echogenicity of the cervix or vastus lateralis and mode of delivery.
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association of first trimester Echogenicity of the puborectalis muscle with mode of delivery
Obstetrics & Gynecology, 2016Co-Authors: Anique T M Grob, M K Van De Waarsenburg, Mariella I J Withagen, Karlijn J Schweitzer, C H Van Der VaartAbstract:OBJECTIVE: To evaluate the association between mean Echogenicity of the puborectalis muscle, measured using transperineal ultrasonography, in women during their first pregnancy and the subsequent mode of delivery. METHODS: This is a secondary analysis of a prospective observational study on the association between stress urinary incontinence and levator muscle avulsion after delivery of a first pregnancy. In this study, 280 nulliparous women with singleton pregnancies were examined with transperineal ultrasound examination at 12 and 36 weeks of gestation. Patients were recruited from an obstetrics practice associated with the university medical center in Utrecht, the Netherlands. Mean Echogenicity of the puborectalis muscle values were measured at rest, in pelvic floor muscle contraction, and during the Valsalva maneuver. The subsequent mode of delivery was classified into five categories: spontaneous vaginal delivery, instrumental vaginal delivery, elective cesarean delivery, cesarean delivery resulting from nonreassuring fetal status, and cesarean delivery resulting from failure to progress. Mean Echogenicity of the puborectalis muscle values according to mode of delivery were compared by analysis of variance and Tukey's post hoc test. RESULTS: Of the 254 women included, 157 had spontaneous vaginal delivery, 47 underwent cesarean delivery (11 elective, 36 emergency), and 45 had vacuum operative vaginal delivery; in five patient files, the mode of delivery was not recorded. Of the analyzed women, those who delivered by cesarean because of failure to progress had a significantly lower mean Echogenicity of the puborectalis muscle in pelvic floor contraction at 12 weeks of gestation (mean Echogenicity of 116±14) than women who had spontaneous vaginal delivery (132±21; Tukey's post hoc test, P=.03), instrumental vaginal delivery (138±21; P=.004), and cesarean delivery resulting from nonreassuring fetal status (139±20; P=.02). CONCLUSION: Lower mean Echogenicity of the puborectalis muscle values in pelvic floor contraction during the first pregnancy at 12 weeks of gestation is associated with subsequent cesarean delivery as a result of failure to progress.
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changes in the mean Echogenicity and area of the puborectalis muscle during pregnancy and postpartum
International Urogynecology Journal, 2016Co-Authors: Anique T M Grob, M K Van De Waarsenburg, Mariella I J Withagen, Karlijn J Schweitzer, C H Van Der VaartAbstract:Introduction and hypothesis Three-dimensional (3D) and four-dimensional (4D) volume transperineal ultrasound imaging is increasingly used to assess changes in the dimensions of the pelvic floor during pregnancy and after delivery. Little is known with regard to the area of the puborectalis muscle and its structural changes. Echogenicity measurement, a parameter that provides information on the structure of muscles, is increasingly used in orthopaedics and neuromuscular disease evaluation. This study is aimed at assessing the changes in the mean Echogenicity of the puborectalis muscle (MEP) and the puborectalis muscle area (PMA) during first pregnancy and after childbirth.
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measuring Echogenicity and area of the puborectalis muscle method and reliability
Ultrasound in Obstetrics & Gynecology, 2014Co-Authors: Anique T M Grob, Mariella I J Withagen, Karlijn J Schweitzer, A Veen, Greetje A Van Veelen, C H Van Der VaartAbstract:OBJECTIVES: To develop a semi-automated method to assess puborectalis muscle Echogenicity on three-dimensional/four-dimensional (3D/4D) volume transperineal ultrasound images using 4D View and Matlab® software and evaluate its intra- and interobserver reliability. METHOD: The data of 23 women in their first trimester were included. 3D/4D volume datasets were obtained at rest. Two inexperienced observers were trained by an experienced observer to construct tomographic ultrasound images (TUI) from the original data and to delineate all structures. Puborectalis muscle area (PMA) and the mean Echogenicity of the puborectalis muscle (MEP) were calculated offline. Intra- and interobserver reliability were determined by intraclass correlation coefficients (ICC) and their 95% CIs. RESULTS: The development of a semi-automated method to calculate puborectalis area and Echogenicity is described in detail. PMA and MEP measurements in pregnant women demonstrated almost perfect intraobserver reliability for both inexperienced observers, with ICC values ranging from 0.88 to 0.99. The interobserver reliability showed ICCs of 0.63 for PMA and almost perfect ICC values, of 0.96-0.98, for Echogenicity. The majority of intraobserver mismatch between two delineations of PMA occurred near the borders. CONCLUSIONS: Matlab software can be used to provide reliable measurements of the area and Echogenicity of the puborectalis muscle. As the latter can be used to assess structural changes in the puborectalis muscle, it appears a promising new tool for studying pelvic floor structural anatomy.
Keitaro Kubo - One of the best experts on this subject based on the ideXlab platform.
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effects of static stretching on mechanical properties and collagen fiber orientation of the achilles tendon in vivo
Clinical Biomechanics, 2018Co-Authors: Keitaro KuboAbstract:Abstract Background The study was designed to examine changes in tendon properties measured during ramp and ballistic contractions after static stretching and to elucidate the relationship between stretching-induced changes in tendon properties (particularly hysteresis) and collagen fiber orientation. Methods Thirteen males performed static stretching, in which the ankle was passively flexed to 36° dorsiflexion and remained stationary for 10 min. Before and after stretching, the stiffness and hysteresis of tendon structures in the medial gastrocnemius muscle were measured using ultrasonography during ramp and ballistic contractions. Tendon collagen fiber orientation was also estimated from the coefficient of variation (CV) of Echogenicity on transverse ultrasonic images of the Achilles tendon. Findings. The hysteresis of tendon structures significantly decreased by 15.5% (p = 0.005) during ramp contractions and by 15.3% (p = 0.003) during ballistic contractions after stretching, whereas stiffness did not. The mean Echogenicity of the Achilles tendon significantly increased by 6.0% (p = 0.002) after stretching, whereas the CV of Echogenicity did not (p = 0.148). Furthermore, the relative change in mean Echogenicity, which reflected interstitial fluid movement within tendons, tended to be correlated to that in hysteresis measured during ballistic contractions (r = 0.439, p = 0.133). Interpretation These results suggest that the hysteresis, but not stiffness, of tendon structures measured during ramp and ballistic contractions significantly decreased after stretching. Furthermore, a decline in the hysteresis of tendon structures after static stretching was associated with interstitial fluid movement within tendons, but not to changes in collagen fiber orientation.
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quantification of collagen fiber orientation in human tendons with the coefficient of variation of Echogenicity
Journal of Biomechanics, 2016Co-Authors: Tomonobu Ishigaki, Masahiro Kouno, Toshihiro Ikebukuro, Keitaro KuboAbstract:Abstract The grayscale distribution on the ultrasonic images of tendons may be reduced with alignment of collagen fibers, because ultrasound signal intensity changes with alterations in tendon collagen fiber orientation due to acoustic anisotropy in the tendons. The purpose of this study was to investigate changes in the coefficient of variation (CV) of Echogenicity in the Achilles tendon during passive dorsiflexion (the angle task) and isometric plantar flexion (the contraction task). Achilles tendon transverse ultrasonic images were collected from 14 healthy individuals every 10° from 20° to −20° (positive values for plantar flexion) in the angle task and every 10% maximum voluntary contraction (MVC) from 0% to 70% MVC in the contraction task. The CV of Echogenicity was measured in each image. In addition, relative changes in the measured variables between the former half (20–0° in the angle task, 0% to 30% MVC in the contraction task) and the latter half (0° to −20° in the angle task, 40% to 70% MVC in the contraction task) of each task were compared. The CV of Echogenicity decreased with increases in the dorsiflexion angle and intensity of isometric contractions. Furthermore, relative changes in the CV of Echogenicity were greater at more dorsiflexed positions in the angle task and at lower torque levels in the contraction task. These results suggested that decreases in the CV of Echogenicity were partially related to the alignment of the tendon collagen fibers with tendon stretching.
Elizabeth Sapey - One of the best experts on this subject based on the ideXlab platform.
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bilateral anterior thigh thickness a new diagnostic tool for the identification of low muscle mass
Journal of the American Medical Directors Association, 2019Co-Authors: Daisy Wilson, Hannah Moorey, Howard Stringer, Ilfita Sahbudin, Andrew Filer, Janet M Lord, Elizabeth SapeyAbstract:Abstract Objectives To develop an ultrasonographic scanning protocol that included an assessment of muscle size [the proposed Bilateral Anterior Thigh Thickness (BATT)] and quality (Echogenicity) to support the diagnosis of sarcopenia in a clinical setting. To determine the relationship of BATT and ultrasound Echogenicity with physical function parameters of sarcopenia and test the reliability of ultrasound Echogenicity measurements. Design Observational study. Setting and participants The BATT criteria were determined from a reference population of 113 healthy younger adults and tested in 39 healthy older adults and 31 frail older adults. Methods Ultrasonography was used to measure the thickness of rectus femoris and vastus intermedius bilaterally; the thickness measurements were summed to calculate the BATT. Diagnostic criteria for low muscle size were calculated from the reference population. Echogenicity was assessed using freeze-frame images. All individuals underwent anthropological, frailty, and physical performance assessments. Results The mean (standard deviation) BATTs for the subsamples were as follows: healthy young women (n = 54), 60.6 mm (±11.1); healthy young men (n = 59), 75.8 mm (±10.71); healthy older women (n = 27), 38.4 mm (±7.18); healthy older men (n = 13), 47.5 mm (±10.8); frail older women (n = 17), 29.2 mm (±11.4); and frail older men (n = 14), 27.3 mm (±13.9). The calculated cutoffs for low muscle size in older adults using the BATT criteria were 38.5 mm in women and 54.4 mm in men in this population. The BATT was correlated with grip strength (ρ = 0.750, P Conclusions/Implications The data support the use of ultrasonography to identify low muscle size in sarcopenia. Ultrasonography provides a pragmatic diagnostic tool that is noninvasive, without radiation exposure, and usable in both community and hospital settings. The proposed BATT criteria could be used to identify low muscle size in clinical practice and research, and in this study have excellent correlation with physical parameters of muscle health. However, this now needs testing in a validation cohort. Ultrasound Echogenicity has been demonstrated to be an important surrogate marker of muscle health, but difficulties with reproducibility preclude its widespread clinical use.
