Three-dimensional transperineal sonographic characteristics of the anal sphincter complex in nulliparous women

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Abstract

Objective To explore the morphological characteristics and normal biometry of the anal sphincter complex in nulliparous Chinese women using three-dimensional (3D) transperineal ultrasound. Methods 3D sonographic data from 55 nulliparous Chinese women (aged 19-38 years) who had no pelvic organ prolapse and no symptoms of pelvic floor dysfunction were retrieved from an image dataset and analyzed by offline post-processing. The morphological characteristics of the external and internal anal sphincters, puborectalis muscle and perineal body were assessed in the sagittal, coronal and axial views. Results The external anal sphincter had three sonographic components: the circular main body, a subcutaneous part and an extension portion. It was significantly thinner at 12 o'clock than at the 3, 6 and 9 o'clock positions. The internal anal sphincter was seen as dark echolucent strips of equal thickness. In the mid-sagittal view, it started from the anal verge and ended at the anorectal junction. The perineal body was an ovoid structure covering the upper margin of the external sphincter, while the puborectalis muscle was banana-shaped in the sagittal view and was located behind the anorectal junction, extending downward along the inferior margin of the posterior external sphincter extension. Sonographic characteristics of the anal sphincter complex did not vary with age, weight, height or body mass index. Conclusions 3D transperineal ultrasound clearly demonstrates the spatial relationships of each component of the anal sphincter complex. This should allow standardized measurement of the complex for investigations of its function.

Original languageEnglish
Pages (from-to)210-220
Number of pages11
JournalUltrasound in Obstetrics and Gynecology
Volume30
Issue number2
DOIs
Publication statusPublished - Aug 2007

Fingerprint

Anal Canal
muscles
clocks
margins
weight (mass)
organs
Biometry
Pelvic Organ Prolapse
Muscles
strip
Musa
Pelvic Floor
coverings
Body Mass Index
Weights and Measures

Keywords

  • Anal sphincter complex
  • External anal sphincter
  • Fecal incontinence
  • Internal anal sphincter
  • Perineal body
  • Puborectalis muscle
  • Three-dimensional ultrasound
  • Transperineal ultrasound

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Radiology Nuclear Medicine and imaging
  • Reproductive Medicine
  • Acoustics and Ultrasonics
  • Radiological and Ultrasound Technology

Cite this

@article{58e6ebaa98714910aea885acbf0deddb,
title = "Three-dimensional transperineal sonographic characteristics of the anal sphincter complex in nulliparous women",
abstract = "Objective To explore the morphological characteristics and normal biometry of the anal sphincter complex in nulliparous Chinese women using three-dimensional (3D) transperineal ultrasound. Methods 3D sonographic data from 55 nulliparous Chinese women (aged 19-38 years) who had no pelvic organ prolapse and no symptoms of pelvic floor dysfunction were retrieved from an image dataset and analyzed by offline post-processing. The morphological characteristics of the external and internal anal sphincters, puborectalis muscle and perineal body were assessed in the sagittal, coronal and axial views. Results The external anal sphincter had three sonographic components: the circular main body, a subcutaneous part and an extension portion. It was significantly thinner at 12 o'clock than at the 3, 6 and 9 o'clock positions. The internal anal sphincter was seen as dark echolucent strips of equal thickness. In the mid-sagittal view, it started from the anal verge and ended at the anorectal junction. The perineal body was an ovoid structure covering the upper margin of the external sphincter, while the puborectalis muscle was banana-shaped in the sagittal view and was located behind the anorectal junction, extending downward along the inferior margin of the posterior external sphincter extension. Sonographic characteristics of the anal sphincter complex did not vary with age, weight, height or body mass index. Conclusions 3D transperineal ultrasound clearly demonstrates the spatial relationships of each component of the anal sphincter complex. This should allow standardized measurement of the complex for investigations of its function.",
keywords = "Anal sphincter complex, External anal sphincter, Fecal incontinence, Internal anal sphincter, Perineal body, Puborectalis muscle, Three-dimensional ultrasound, Transperineal ultrasound",
author = "Huang, {W. C.} and Yang, {S. H.} and Yang, {J. M.}",
year = "2007",
month = "8",
doi = "10.1002/uog.4083",
language = "English",
volume = "30",
pages = "210--220",
journal = "Ultrasound in Obstetrics and Gynecology",
issn = "0960-7692",
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AU - Huang, W. C.

AU - Yang, S. H.

AU - Yang, J. M.

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N2 - Objective To explore the morphological characteristics and normal biometry of the anal sphincter complex in nulliparous Chinese women using three-dimensional (3D) transperineal ultrasound. Methods 3D sonographic data from 55 nulliparous Chinese women (aged 19-38 years) who had no pelvic organ prolapse and no symptoms of pelvic floor dysfunction were retrieved from an image dataset and analyzed by offline post-processing. The morphological characteristics of the external and internal anal sphincters, puborectalis muscle and perineal body were assessed in the sagittal, coronal and axial views. Results The external anal sphincter had three sonographic components: the circular main body, a subcutaneous part and an extension portion. It was significantly thinner at 12 o'clock than at the 3, 6 and 9 o'clock positions. The internal anal sphincter was seen as dark echolucent strips of equal thickness. In the mid-sagittal view, it started from the anal verge and ended at the anorectal junction. The perineal body was an ovoid structure covering the upper margin of the external sphincter, while the puborectalis muscle was banana-shaped in the sagittal view and was located behind the anorectal junction, extending downward along the inferior margin of the posterior external sphincter extension. Sonographic characteristics of the anal sphincter complex did not vary with age, weight, height or body mass index. Conclusions 3D transperineal ultrasound clearly demonstrates the spatial relationships of each component of the anal sphincter complex. This should allow standardized measurement of the complex for investigations of its function.

AB - Objective To explore the morphological characteristics and normal biometry of the anal sphincter complex in nulliparous Chinese women using three-dimensional (3D) transperineal ultrasound. Methods 3D sonographic data from 55 nulliparous Chinese women (aged 19-38 years) who had no pelvic organ prolapse and no symptoms of pelvic floor dysfunction were retrieved from an image dataset and analyzed by offline post-processing. The morphological characteristics of the external and internal anal sphincters, puborectalis muscle and perineal body were assessed in the sagittal, coronal and axial views. Results The external anal sphincter had three sonographic components: the circular main body, a subcutaneous part and an extension portion. It was significantly thinner at 12 o'clock than at the 3, 6 and 9 o'clock positions. The internal anal sphincter was seen as dark echolucent strips of equal thickness. In the mid-sagittal view, it started from the anal verge and ended at the anorectal junction. The perineal body was an ovoid structure covering the upper margin of the external sphincter, while the puborectalis muscle was banana-shaped in the sagittal view and was located behind the anorectal junction, extending downward along the inferior margin of the posterior external sphincter extension. Sonographic characteristics of the anal sphincter complex did not vary with age, weight, height or body mass index. Conclusions 3D transperineal ultrasound clearly demonstrates the spatial relationships of each component of the anal sphincter complex. This should allow standardized measurement of the complex for investigations of its function.

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KW - Three-dimensional ultrasound

KW - Transperineal ultrasound

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