Statistical Shape Modelling of the Levator Ani with Thickness Variation

The levator ani is vulnerable to injury during childbirth and effective surgical intervention requires full knowledge of the morphology and mechanical properties of the muscle structure. The shape of the levator ani and regional thickening during different levels of physiological loading can provide an indication of pelvic floor dysfunction. This paper describes a coupled approach for shape and thickness statistical modelling based on harmonic embedding for volumetric analysis of the levator ani. With harmonic embedding, the dynamic information extracted by the statistical modelling captures shape and thickness variation of the levator ani across different subjects and during varying levels of stress. With this study, we demonstrate that the derived model is compact and physiologically meaningful, demonstrating the practical value of the technique.