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Shear Anisotropy Changes of Levator Ani Muscle Phantoms Assessed by Rotational Shear Wave Elastography
KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Biomedical Engineering and Health Systems, Medical Imaging. Intervention and Technology - Karolinska Institutet, Clinical Science, Sweden.ORCID iD: 0009-0009-2233-1752
KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Biomedical Engineering and Health Systems.
Karolinska University Hospital, Clinical Science Pregnancy Care & Delivery, Sweden.
Intervention and Technology - Karolinska Institutet, Clinical Science, Sweden; Karolinska University Hospital, Clinical Science Pregnancy Care & Delivery, Sweden.
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2025 (English)In: 2025 IEEE International Ultrasonics Symposium, IUS 2025, Institute of Electrical and Electronics Engineers (IEEE) , 2025Conference paper, Published paper (Refereed)
Abstract [en]

Over 10% of women experience levator ani muscle (LAM) injuries during childbirth. Yet, the limited knowledge of LAM physiopathology restricts progress in prevention, diagnosis, and treatment. Shear wave elastography (SWE), an ultrasound technique for quantifying tissue elasticity, offers potential for detecting related mechanical changes. However, its clinical application is constrained by isotropy assumptions, which do not hold true for the anisotropic LAM. This study aims to develop LAM phantoms with varied mechanical properties and investigate rotational SWE to assess changes in shear anisotropy. Four phantoms mimicking the puborectalis fiber network were made using high-and low-density nylon or polyethylene (PE) fibers in a polyvinyl alcohol hydrogel, subjected to one or two freeze-thaw cycles. An additional phantom with combined puborectalis-pubococcygeus fiber networks was created to compare with the similar phantom with isolated puborectalis fibers. Using a Verasonics V1 system and a custom rotational setup, shear wave velocities were estimated by applying the Radon transform to axial velocity maps and fitting the results to an elliptical model. The rotational SWE imaging allowed to distinguish phantoms mimicking different physiopathological states and age groups. High-density nylon phantoms with one or two freeze-thaw cycles reflected LAM at rest or stretched states as well as elasticity differences related to delivery mode. The low-density nylon phantom showed reduced anisotropy, suggesting overdistension, while the PE phantom exhibited higher anisotropy and elasticity, resembling a contracted LAM in younger women. The combined puborectalis-pubococcygeus phantom further showed that adjacent fiber networks affected shear wave propagation, reducing signal quality and altering shear properties. Despite limitations on phantom construction, these findings support in-vivo research into LAM pathophysiology using SWE.

Place, publisher, year, edition, pages
Institute of Electrical and Electronics Engineers (IEEE) , 2025.
Keywords [en]
anisotropy, elastography, Levator ani muscle, tissue-mimicking phantoms
National Category
Medical Imaging Radiology and Medical Imaging
Identifiers
URN: urn:nbn:se:kth:diva-373346DOI: 10.1109/IUS62464.2025.11201414Scopus ID: 2-s2.0-105021808758OAI: oai:DiVA.org:kth-373346DiVA, id: diva2:2018168
Conference
2025 IEEE International Ultrasonics Symposium, IUS 2025, Utrecht, Netherlands, Kingdom of the, September 15-18, 2025
Note

Part of ISBN 9798331523329

QC 20251202

Available from: 2025-12-02 Created: 2025-12-02 Last updated: 2025-12-02Bibliographically approved

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Pitti, EstelleValembois, AuxaneLi, XiaogaiLarsson, Matilda

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