Levator hiatus width as a complementary measurement tool in assessing pelvic floor dysfunction.

Authors

Anu P Gayathri, Perla Subbaiah, Leila Neshatian, Brooke Gurland, Vipul Sheth

Published in

Current problems in diagnostic radiology. Nov 13, 2026. Epub Nov 13, 2026.

Abstract

Levator hiatus width (LHW) is a measurement along with H- and M-lines in MR defecography to evaluate pelvic floor dysfunction. Our study aimed to correlate the resting LHW with the resting and defecation-phase H-line and M-line, the presence of pelvic organ prolapse (POP), and to evaluate the reliability of measurement between readers.
This Institutional Review Board (IRB) approved case-control study retrospectively reviewed MR defecography exams of 70 patients with symptomatic pelvic floor dysfunction and 19 age-matched controls. LHW, H-line, and M-line in resting (RPH, RPM) and dynamic defecation phases (DPH, DPM) were measured, and the anterior, middle, and posterior compartment pelvic floor descent was graded. Three readers analyzed each exam, and their interobserver variability was compared.
LHW was abnormal (>4.5 cm) in 29 patients (41.4%). Mean (± SD) LHW was 4.4 ± 1.1 cm in patients and 3.7±1.0 cm in controls. Abnormal LHW was significantly associated with RPH (P<0.001), RPM (P<0.001), and several compartment-specific prolapse findings on logistic regression, including bladder descent, vaginal descent, enterocele, and sigmoidocele. Intraclass correlation coefficients showed greater agreement between the two readers with dedicated training to read MR defecography.
Resting LHW was associated with several MRI markers of POP and may provide complementary information during MR defecography. Its added diagnostic value beyond H-line and M-line was not formally assessed in this exploratory analysis and requires validation. Dedicated training in reporting MR defecography can reduce interobserver variability in interpretations.

PMID:
43034133
Bibliographic data and abstract were imported from PubMed on 15 Nov 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.