Induced transducer orientation during ultrasound imaging: effects on abdominal muscle thickness and bladder position

Whittaker, J., Warner, M. and Stokes, M. (2009) Induced transducer orientation during ultrasound imaging: effects on abdominal muscle thickness and bladder position. Ultrasound in Medicine & Biology, 35, (11), 1803-1811. (doi:10.1016/j.ultrasmedbio.2009.05.018).

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The use of ultrasound imaging (USI) by physiotherapists to assess muscle behavior in clinical settings is
increasing. However, there is relatively little evidence of whether the clinical environment is conducive to valid and
reliable measurements. Accurate USI measurements depend on maintaining a relatively stationary transducer
position, because motion may distort the image and lead to erroneous conclusions. This would seem particularly
important during dynamic studies typical of a physiotherapy assessment. What is not known is how much
transducer motion can occur before error is introduced. The aim of this study is to shed some light on this question.
Eight healthy volunteers (19 to 52 y) participated. USI images were taken of the lateral abdominal wall (LAW) and
bladder base (midline suprapubic) at various manually induced transducer orientations (approximately –10 to 10
about 3 axes of rotation), which were quantified by a digital optical motion capture system. Measurements of
transversus abdominis (TrA) thickness and bladder base position (cranial /caudal and anterior/posterior) were
calculated. Repeated measures analysis of variance was performed to determine if the measurements obtained
at the induced transducer orientations were statistically different (p,0.05) from an image corresponding to
a reference or starting transducer orientation. Motion analysis data corresponding to measurements that did
not differ from reference image measurements were summarized to provide a range of acceptable transducer
motion (relative to the pelvis) for clockwise (CW)/counter-clockwise (CCW) rotation, cranial/caudal tilting,
medial/lateral tilting and inward/outward displacement. There were no significant changes in TrA thickness
measurements if CW/CCW transducer motion was ,9 and cranial/caudal or medial/lateral transducer tilting
was ,5. Further, there were no significant changes in measurements of bladder base position if CW/CCW
transducer motion was ,10, cranial/caudal or medial/lateral transducer tilting was ,10 and 8, respectively
and inward/outward motion was ,8 mm. These findings provide guidance on acceptable amounts of transducer
motion relative to the pelvis when generating measurements of TrA thickness and bladder base position. Future
sonographic studies and clinical assessment investigating these parameters could take these findings into account
to improve imaging technique reliability

Item Type: Article
Digital Object Identifier (DOI): doi:10.1016/j.ultrasmedbio.2009.05.018
ISSNs: 0301-5629 (print)
Related URLs:
Keywords: bladder position, transversus abdominis, ultrasound imaging, ultrasound transducer, validity
Subjects: Q Science > QP Physiology
Q Science > QM Human anatomy
Q Science > QC Physics
Divisions : University Structure - Pre August 2011 > School of Health Sciences
ePrint ID: 69357
Accepted Date and Publication Date:
August 2009Published
Date Deposited: 04 Nov 2009
Last Modified: 31 Mar 2016 12:57

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