Ultrasound tissue characterization of PRM

The female pelvic floor muscles provide support to the pelvic floor organs and also facilitates the passage of the baby during delivery. This group of muscles is known as the levator ani muscles (LAM). The puborectalis muscle (PRM) is one of the muscles in LAM. PRM can stretch up to 250% of their original length during vaginal delivery. This may cause permanent muscle trauma. As a consequence, one fourth to one-sixth of all women above the age of sixty suffer from urinary or faecal incontinence and pelvic organ prolapse (POP), respectively. This can cause major inconveniences in their daily life. To better understand the mechanisms associated with the pelvic floor muscles, it is necessary to obtain functional and diagnostic information about these muscles.

In order to observe these muscle movements, particularly the PRM, 3D/4D Transperineal Ultrasound (TPUS) is used. While a female candidate voluntarily contracts and relaxes her muscles, the movements of the pelvic muscles are captured in US volumes. Although MRI scans generate better images than Ultrasound, they are also more expensive.

The goal of this master assignment is to develop a quantitative ultrasound (QUS) tissue characterization technique that can detect pathological changes due to muscle trauma in the PRM. For this purpose, US images of the PRM will be analyzed and through appropriate techniques and models, the state of the muscular tissue will be evaluated. Examples of such techniques are Nakagami imaging and estimation of echogenicity parameter. Ideally, the method should be fully automated and provide an accurate classification of whether the PRM is damaged or not.