{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T23:21:10Z","timestamp":1789514470258,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,4,3]],"date-time":"2017-04-03T00:00:00Z","timestamp":1491177600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet & Gyne"],"published-print":{"date-parts":[[2017,4]]},"abstract":"ABSTRACT<\/jats:title>Objective<\/jats:title>To compare the sensitivity and specificity of two\u2010 (2D<\/jats:styled-content>) and three\u2010 (3D<\/jats:styled-content>) dimensional transperineal ultrasound (TPUS<\/jats:styled-content>) and 3D<\/jats:styled-content> endovaginal ultrasound (EVUS<\/jats:styled-content>) with the gold standard 3D endoanal ultrasound (EAUS)<\/jats:styled-content> in detecting residual defects after primary repair of obstetric anal sphincter injuries (OASIS<\/jats:styled-content>).<\/jats:p><\/jats:sec>Methods<\/jats:title>External (EAS<\/jats:styled-content>) and internal (IAS<\/jats:styled-content>) anal sphincters were evaluated by the four ultrasound modalities in women with repaired OASIS<\/jats:styled-content>. 2D\u2010TPUS<\/jats:styled-content> was evaluated in real\u2010time, whereas 3D\u2010TPUS<\/jats:styled-content>, 3D\u2010EVUS<\/jats:styled-content> and 3D\u2010EAUS<\/jats:styled-content> volumes were evaluated offline by six blinded readers. The presence\/absence of any tear in EAS<\/jats:styled-content> or IAS<\/jats:styled-content> was recorded and defects were scored according to the Starck system. Sensitivity, specificity and predictive values were calculated, using 3D\u2010EAUS<\/jats:styled-content> as reference standard. Inter\u2010 and intraobserver analyses were performed for all 3D<\/jats:styled-content> imaging modalities. Association between patients' symptoms (Wexner score) and ultrasound findings (Starck score) was calculated.<\/jats:p><\/jats:sec>Results<\/jats:title>Images from 55 patients were analyzed. Compared with findings on 3D\u2010EAUS<\/jats:styled-content>, the agreement for EAS<\/jats:styled-content> evaluation was poor for 3D\u2010EVUS<\/jats:styled-content> (\u03ba\u2009=\u20090.01), fair for 2D\u2010TPUS<\/jats:styled-content> (\u03ba\u2009=\u20090.30) and good for 3D\u2010TPUS<\/jats:styled-content> (\u03ba\u2009=\u20090.73). The agreement for IAS<\/jats:styled-content> evaluation was moderate for both 3D\u2010EVUS<\/jats:styled-content> (\u03ba\u2009=\u20090.41) and 2D\u2010TPUS<\/jats:styled-content> (\u03ba\u2009=\u20090.52) and good for 3D\u2010TPUS<\/jats:styled-content> (\u03ba\u2009=\u20090.66). Good intraobserver (3D\u2010EAUS<\/jats:styled-content>, \u03ba\u2009=\u20090.73; 3D\u2010TPUS<\/jats:styled-content>, \u03ba\u2009=\u20090.78) and interobserver (3D\u2010EAUS<\/jats:styled-content>, \u03ba\u2009=\u20090.68; 3D\u2010TPUS<\/jats:styled-content>, \u03ba\u2009=\u20090.60) agreement was reported. Significant association between Starck and Wexner scores was found only for 3D\u2010EAUS<\/jats:styled-content> (Spearman's rho\u2009=\u20090.277, P<\/jats:italic>\u2009=\u20090.04).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>2D\u2010TPUS<\/jats:styled-content> and 3D\u2010EVUS<\/jats:styled-content> are not accurate modalities for the assessment of anal sphincters after repair of OASIS<\/jats:styled-content>. 3D\u2010TPUS<\/jats:styled-content> shows good agreement with the gold standard 3D\u2010EAUS<\/jats:styled-content> and a high sensitivity in detecting residual defects. It, thus, has potential as a screening tool after primary repair of OASIS<\/jats:styled-content>. Copyright \u00a9 2016 ISUOG. Published by John Wiley & Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.15924","type":"journal-article","created":{"date-parts":[[2016,3,22]],"date-time":"2016-03-22T13:05:14Z","timestamp":1458651914000},"page":"508-514","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Postpartum two\u2010 and three\u2010dimensional ultrasound evaluation of anal sphincter complex in women with obstetric anal sphincter injury"],"prefix":"10.1002","volume":"49","author":[{"given":"C.","family":"Ros","sequence":"first","affiliation":[{"name":"Pelvic Floor Unit, ICGON, Hospital Clinic de Barcelona Universitat de Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Mart\u00ednez\u2010Franco","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Parc Sanitari Sant Joan de D\u00e9u, Sant Boi del Llobregat Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. M.","family":"Wozniak","sequence":"additional","affiliation":[{"name":"Department of Pediatric Radiology Medical University of Lublin Lublin Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Cassado","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital Universitari Mutua de Terrassa Terrassa Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. A.","family":"Santoro","sequence":"additional","affiliation":[{"name":"Pelvic Floor Unit, First Department of Surgery Treviso Regional Hospital Treviso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"El\u00edas","sequence":"additional","affiliation":[{"name":"Pelvic Floor Unit, ICGON, Hospital Clinic de Barcelona Universitat de Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"BCNatal\u00a0\u2013\u00a0Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u), IDIBAPS Universitat de Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Palacio","sequence":"additional","affiliation":[{"name":"BCNatal\u00a0\u2013\u00a0Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u), IDIBAPS Universitat de Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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