Rendimiento diagnóstico de la ecografía 3d comparada con resonancia magnética, para la evaluación de incontinencia urinaria. Revisión sistemática

La incontinencia urinaria es una condición subdiagnosticada. Su prevalencia aumenta con la edad y a cualquier edad es más de dos veces más frecuente en mujeres que en hombres. Afecta del 50-84% de los ancianos en los servicios de cuidado crónico. En mujeres occidentales tiene una prevalencia de hast...

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Autores:
Medina Ramírez, Roger David
Tipo de recurso:
Informe
Fecha de publicación:
2020
Institución:
Universidad Nacional de Colombia
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Universidad Nacional de Colombia
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spa
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oai:repositorio.unal.edu.co:unal/75560
Acceso en línea:
https://repositorio.unal.edu.co/handle/unal/75560
Palabra clave:
Medicina y salud
Incontinencia urinaria; Ultrasonido tridimensional; Resonancia magnética; Piso pélvico; Revisión sistemática
Urinary Incontinence; Ultrasonography; Magnetic Resonance Imaging; Pelvic Floor Disorders
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openAccess
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Atribución-NoComercial 4.0 Internacional
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oai_identifier_str oai:repositorio.unal.edu.co:unal/75560
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network_name_str Universidad Nacional de Colombia
repository_id_str
dc.title.spa.fl_str_mv Rendimiento diagnóstico de la ecografía 3d comparada con resonancia magnética, para la evaluación de incontinencia urinaria. Revisión sistemática
dc.title.alternative.spa.fl_str_mv Diagnostic performance of 3d ultrasound compared to magnetic resonance, for the evaluation of urinary incontinence. Systematic review
title Rendimiento diagnóstico de la ecografía 3d comparada con resonancia magnética, para la evaluación de incontinencia urinaria. Revisión sistemática
spellingShingle Rendimiento diagnóstico de la ecografía 3d comparada con resonancia magnética, para la evaluación de incontinencia urinaria. Revisión sistemática
Medicina y salud
Incontinencia urinaria; Ultrasonido tridimensional; Resonancia magnética; Piso pélvico; Revisión sistemática
Urinary Incontinence; Ultrasonography; Magnetic Resonance Imaging; Pelvic Floor Disorders
title_short Rendimiento diagnóstico de la ecografía 3d comparada con resonancia magnética, para la evaluación de incontinencia urinaria. Revisión sistemática
title_full Rendimiento diagnóstico de la ecografía 3d comparada con resonancia magnética, para la evaluación de incontinencia urinaria. Revisión sistemática
title_fullStr Rendimiento diagnóstico de la ecografía 3d comparada con resonancia magnética, para la evaluación de incontinencia urinaria. Revisión sistemática
title_full_unstemmed Rendimiento diagnóstico de la ecografía 3d comparada con resonancia magnética, para la evaluación de incontinencia urinaria. Revisión sistemática
title_sort Rendimiento diagnóstico de la ecografía 3d comparada con resonancia magnética, para la evaluación de incontinencia urinaria. Revisión sistemática
dc.creator.fl_str_mv Medina Ramírez, Roger David
dc.contributor.advisor.spa.fl_str_mv Lozano Castillo, Alfonso Javier
dc.contributor.author.spa.fl_str_mv Medina Ramírez, Roger David
dc.contributor.researchgroup.spa.fl_str_mv GRUPO DE INVESTIGACIÓN EN RADIOLOGÍA E IMÁGENES DIAGNÓSTICAS (GRID)
dc.subject.ddc.spa.fl_str_mv Medicina y salud
topic Medicina y salud
Incontinencia urinaria; Ultrasonido tridimensional; Resonancia magnética; Piso pélvico; Revisión sistemática
Urinary Incontinence; Ultrasonography; Magnetic Resonance Imaging; Pelvic Floor Disorders
dc.subject.proposal.spa.fl_str_mv Incontinencia urinaria; Ultrasonido tridimensional; Resonancia magnética; Piso pélvico; Revisión sistemática
dc.subject.proposal.eng.fl_str_mv Urinary Incontinence; Ultrasonography; Magnetic Resonance Imaging; Pelvic Floor Disorders
description La incontinencia urinaria es una condición subdiagnosticada. Su prevalencia aumenta con la edad y a cualquier edad es más de dos veces más frecuente en mujeres que en hombres. Afecta del 50-84% de los ancianos en los servicios de cuidado crónico. En mujeres occidentales tiene una prevalencia de hasta el 38%, y aumenta con la edad. Para lograr un adecuado manejo de esta patología es importante evaluar de forma detallada la función y anatomía del piso pélvico de cada paciente. Hasta hace algunos años la resonancia magnética era el único estudio por imágenes diagnósticas con la capacidad de evaluar los músculos que compone el piso pélvico, que son primordiales para la continencia urinaria. Sin embargo su costo, escasa disponibilidad y contraindicaciones limitan su uso masivo en la práctica clínica. Con la introducción del ultrasonido de alta resolución y de los traductores volumétricos a sido posible evaluar en tiempo real (4D) y de forma dinámica el piso pélvico. Esta modalidad diagnóstica brinda información cualitativa y cuantitativa de la función de los músculos, y permite visualizar avulsiones y alteraciones anatómicas con una buena sensibilidad. El objetivo de este trabajo es realizar una revisión sistemática del rendimiento diagnóstico del ultrasonido 3D por vía transperineal versus la resonancia magnética de pelvis, para la evaluación de alteraciones anatómicas en mujeres con incontinencia urinaria.
publishDate 2020
dc.date.accessioned.spa.fl_str_mv 2020-02-07T14:31:10Z
dc.date.available.spa.fl_str_mv 2020-02-07T14:31:10Z
dc.date.issued.spa.fl_str_mv 2020-01-31
dc.type.spa.fl_str_mv Reporte
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/report
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dc.type.content.spa.fl_str_mv Text
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dc.identifier.uri.none.fl_str_mv https://repositorio.unal.edu.co/handle/unal/75560
url https://repositorio.unal.edu.co/handle/unal/75560
dc.language.iso.spa.fl_str_mv spa
language spa
dc.relation.references.spa.fl_str_mv 1. Katya Carrillo G, Antonella Sanguineti M. Anatomía del piso pélvico. Rev Médica Clínica Las Condes [Internet]. 2013;24(2):185–9. Available from: http://www.elsevier.es/es-revista-revista-medica-clinica-las-condes-202-articulo-anatomia-del-piso-pelvico-S0716864013701482 2. Erdem N, Chu FM. Management of overactive bladder and urge urinary incontinence in the elderly patient. Am J Med. 2006 Mar;119(3 Suppl 1):29–36. 3. Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997 Apr;89(4):501–6. 4. Ebert AK, Falkert A, Brandl R, Hirschfelder H, Koller M, Rosch WH. Pelvic-floor imaging using three-dimensional ultrasonography and magnetic resonance imaging in the long term follow-up of the bladder-exstrophy-epispadias complex. BJU Int. 2009/07/09. 2010;105(2):248–53. 5. Allen RE, Hosker GL, Smith AR, Warrell DW. Pelvic floor damage and childbirth: a neurophysiological study. Br J Obstet Gynaecol. 1990 Sep;97(9):770–9. 6. Wijma J, Weis Potters AE, de Wolf BT, Tinga DJ, Aarnoudse JG. Anatomical and functional changes in the lower urinary tract during pregnancy. BJOG. 2001 Jul;108(7):726–32. 7. ACOG Practice Bulletin No. 155: Urinary Incontinence in Women. Obstet Gynecol. 2015 Nov;126(5):e66-81. 8. Nazir T, Khan Z, Barber HR. Urinary incontinence. Clin Obstet Gynecol. 1996 Dec;39(4):906–11. 9. Dietz HP, Hoyte LPJ, Steensma AB. Atlas of pelvic floor ultrasound. London: Springer; 2008. 10. Dietz HP, Gillespie AVL, Phadke P. Avulsion of the pubovisceral muscle associated with large vaginal tear after normal vaginal delivery at term. Aust New Zeal J Obstet Gynaecol [Internet]. 2007;47(4):341–4. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L47079565 11. Mundial A médica. Principios éticos para las investigaciones médicas en seres humanos. 1964. p. 1–9. 12. Ministerio de Salud. Republica de Colombia. Resolucion No 8430 de 1993 - 1. Por la cual se establecen las normas científicas, técnicas y administrativas para la investigación en salud. Colombia; 1993 p. 1–12. 13. Preparadas por el Consejo de Organizaciones internacionales de las Ciencias Médicas (CIOMS) en colaboración con la Organización Mundial de la Salud. Pautas éticas internacionales para la investigación biomédica en seres humanos. 2002. 14. Vergeldt TF, Notten KJ, Stoker J, Futterer JJ, Beets-Tan RG, Vliegen RF, et al. Comparison of translabial three-dimensional ultrasound with magnetic resonance imaging for measurement of levator hiatal biometry at rest. Ultrasound Obs Gynecol. 2015/07/17. 2016;47(5):636–41. 15. Stoker J, Bartram CI, Halligan S. Imaging of the posterior pelvic floor. Eur Radiol. 2002/04/18. 2002;12(4):779–88. 16. Dietz HP, Hyland G, Hay-Smith J. The assessment of levator trauma: A comparison between palpation and 4D pelvic floor ultrasound. Neurourol Urodyn [Internet]. 2006;25(5):424–7. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L44246635 17. Savoye-Collet C, Koning E, Dacher JN. Radiologic evaluation of pelvic floor disorders. Gastroenterol Clin North Am. 2008/09/17. 2008;37(3):553–67, viii. 18. Schwertner-Tiepelmann N, Thakar R, Sultan AH, Tunn R. Obstetric levator ani muscle injuries: current status. Ultrasound Obstet Gynecol [Internet]. 2012;39(4):372–83. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L365721148 19. Majida M, Braekken IH, Bø K, Benth JS, Engh ME. Validation of three-dimensional perineal ultrasound and magnetic resonance imaging measurements of the pubovisceral muscle at rest. Ultrasound Obstet Gynecol [Internet]. 2010;35(6):715–22. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L360232987 20. Cuicchi D, Lombardi R, Cariani S, Leuratti L, Lecce F, Cola B. Clinical and instrumental evaluation of pelvic floor disorders before and after bariatric surgery in obese women. Surg Obes Relat Dis [Internet]. 2013;9(1):69–75. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L51648285 21. Lammers K, Fütterer JJ, Prokop M, Vierhout ME, Kluivers KB. Diagnosing pubovisceral avulsions: A systematic review of the clinical relevance of a prevalent anatomical defect. Int Urogynecol J Pelvic Floor Dysfunct [Internet]. 2012;23(12):1653–64. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L369383500 22. DeLancey JOL, Miller JM, Kearney R, Howard D, Reddy P, Umek W, et al. Vaginal birth and de novo stress incontinence: Relative contributions of urethral dysfunction and mobility. Obstet Gynecol [Internet]. 2007;110(2 I):354–62. Available from: http://dx.doi.org/10.1097/01.AOG.0000270120.60522.55 23. Zhuang RR, Song YF, Chen ZQ, Ma M, Huang HJ, Chen JH, et al. Levator avulsion using a tomographic ultrasound and magnetic resonancebased model. Am J Obstet Gynecol [Internet]. 2011;205(3):232.e1-232.e8. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L51445051 24. Nardos R, Thurmond A, Holland A, Gregory WT. Pelvic floor levator hiatus measurements: MRI versus ultrasound. Female Pelvic Med Reconstr Surg [Internet]. 2014;20(4):216–21. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L373745542 25. Tunn R, Perucchini D. [Morphologic assessment for diagnosing urogynaecologic disorders]. Zentralbl Gynakol. 2002/02/12. 2001;123(12):672–9. 26. Eguare EI, Neary P, Crosbie J, Johnston SM, Beddy P, McGovern B, et al. Dynamic magnetic resonance imaging of the pelvic floor in patients with idiopathic combined fecal and urinary incontinence. J Gastrointest Surg [Internet]. 2004;8(1):73–82. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L38117280 27. Constantinou CE. Dynamics of female pelvic floor function using urodynamics, ultrasound and Magnetic Resonance Imaging (MRI). Eur J Obs Gynecol Reprod Biol. 2009/03/24. 2009;144 Suppl:S159-65. 28. Morakkabati-Spitz N, Gieseke J, Willinek WA, Bastian PJ, Schmitz B, Träber F, et al. Dynamic pelvic floor MR imaging at 3 T in patients with clinical signs of urinary incontinence-preliminary results. Eur Radiol [Internet]. 2008;18(11):2620–7. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L50157608 29. Vergeldt TFM, Weemhoff M, Notten KJB, Kessels AGH, Kluivers KB. Comparison of two scoring systems for diagnosing levator ani muscle damage. Int Urogynecol J Pelvic Floor Dysfunct [Internet]. 2013;24(9):1501–6. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L372168012 30. Medina Bueno GA, Hancco Zirena I, Melgar Condori YC, Mayta Carcausto AA. Valor predictivo de la ecografía uretrovesical transperineal en el diagnóstico de la incontinencia urinaria femenina. Acta Médica Peru [Internet]. 2007;24(3):181–6. Available from: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1728-59172007000300010&lang=es 31. Martellucci J, Brusciano L. The Dynamic Transperineal Ultrasound Era of the Evaluation of Obstructed Defecation Syndrome. Dis Colon Rectum. 2016/07/08. 2016;59(8):800–3. 32. Beer-Gabel M, Teshler M, Barzilai N, Lurie Y, Malnick S, Bass D, et al. Dynamic transperineal ultrasound in the diagnosis of pelvic floor disorders: Pilot study. Dis Colon Rectum [Internet]. 2002;45(2):239–48. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L34141949 33. Van Geelen H, Ostergard D, Sand P. A review of the impact of pregnancy and childbirth on pelvic floor function as assessed by objective measurement techniques. Int Urogynecol J. 2018 Mar;29(3):327–38. 34. Vitton V, Vignally P, Barthet M, Cohen V, Durieux O, Bouvier M, et al. Dynamic anal endosonography and MRI defecography in diagnosis of pelvic floor disorders: Comparison with conventional defecography. Dis Colon Rectum [Internet]. 2011;54(11):1398–404. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L362868829 35. Kruger J, Dietz P, Botelho C, Dumoulin C. Can we “feel” with our fingers as well as we “see” with ultrasound? Int Urogynecol J Pelvic Floor Dysfunct [Internet]. 2010;21:S372–3. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L71622084 36. Kruger JA, Heap SW, Murphy BA, Dietz HP. How best to measure the levator hiatus: evidence for the non-Euclidean nature of the “plane of minimal dimensions.” Ultrasound Obstet Gynecol [Internet]. 2010;36(6):755–8. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L360283787 37. Woodfield CA, Krishnamoorthy S, Hampton BS, Brody JM. Imaging pelvic floor disorders: trend toward comprehensive MRI. AJR Am J Roentgenol. 2010/05/22. 2010;194(6):1640–9. 38. Unger CA, Weinstein MM, Pretorius DH. Pelvic floor imaging. Obs Gynecol Clin North Am. 2011/03/23. 2011;38(1):23–43, vii. 39. Kruger JA, Heap SW, Murphy BA, et al. Pelvic floor function in nulliparous women using three-dimensional ultrasound and magnetic resonance imaging. Obstet Gynecol 2008;111(3):631Y638. 40. Notten KJ, Weemhoff M, Kluivers KB, Schweitzer KJ, Mulder F, Stoker J, et al. Protocol for translabial 3D-ultrasonography for diagnosing levator defects (TRUDIL): a multicentre cohort study for estimating the diagnostic accuracy of translabial 3D-ultrasonography of the pelvic floor as compared to MR imaging. BMC Womens Heal. 2011/06/07. 2011;11:23.
dc.rights.spa.fl_str_mv Derechos reservados - Universidad Nacional de Colombia
dc.rights.coar.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.rights.license.spa.fl_str_mv Atribución-NoComercial 4.0 Internacional
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dc.publisher.branch.spa.fl_str_mv Universidad Nacional de Colombia - Sede Bogotá
institution Universidad Nacional de Colombia
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spelling Atribución-NoComercial 4.0 InternacionalDerechos reservados - Universidad Nacional de ColombiaAcceso abiertohttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Lozano Castillo, Alfonso Javier4ec5a252-8502-4d0a-8417-f020cbc524da-1Medina Ramírez, Roger David32d463b1-f59b-40c7-acb5-e479838b5a9fGRUPO DE INVESTIGACIÓN EN RADIOLOGÍA E IMÁGENES DIAGNÓSTICAS (GRID)2020-02-07T14:31:10Z2020-02-07T14:31:10Z2020-01-31https://repositorio.unal.edu.co/handle/unal/75560La incontinencia urinaria es una condición subdiagnosticada. Su prevalencia aumenta con la edad y a cualquier edad es más de dos veces más frecuente en mujeres que en hombres. Afecta del 50-84% de los ancianos en los servicios de cuidado crónico. En mujeres occidentales tiene una prevalencia de hasta el 38%, y aumenta con la edad. Para lograr un adecuado manejo de esta patología es importante evaluar de forma detallada la función y anatomía del piso pélvico de cada paciente. Hasta hace algunos años la resonancia magnética era el único estudio por imágenes diagnósticas con la capacidad de evaluar los músculos que compone el piso pélvico, que son primordiales para la continencia urinaria. Sin embargo su costo, escasa disponibilidad y contraindicaciones limitan su uso masivo en la práctica clínica. Con la introducción del ultrasonido de alta resolución y de los traductores volumétricos a sido posible evaluar en tiempo real (4D) y de forma dinámica el piso pélvico. Esta modalidad diagnóstica brinda información cualitativa y cuantitativa de la función de los músculos, y permite visualizar avulsiones y alteraciones anatómicas con una buena sensibilidad. El objetivo de este trabajo es realizar una revisión sistemática del rendimiento diagnóstico del ultrasonido 3D por vía transperineal versus la resonancia magnética de pelvis, para la evaluación de alteraciones anatómicas en mujeres con incontinencia urinaria.Urinary incontinence is an underdiagnosed condition. Its prevalence increases with age and at any age is more than twice as frequent in women than in men. It affects 50-84% of the elderly in chronic care services. In western women it has a prevalence of up to 38%, and increases with age. To achieve an adequate management of this pathology it is important to evaluate in detail the function and anatomy of the pelvic floor of each patient. Until a few years ago, MRI was the only diagnostic imaging study with the ability to evaluate the muscles that make up the pelvic floor, which are essential for urinary continence. However, its cost, low availability and contraindications limit its massive use in clinical practice. With the introduction of high resolution ultrasound and volumetric probes it has been possible to evaluate the pelvic floor in real time (4D) and in a dynamic way. This diagnostic modality provides qualitative and quantitative information on muscle function, and allows visualization of avulsions and anatomical alterations with good sensitivity. The objective of this work is to perform a systematic review of the diagnostic performance of 3D ultrasound by the transperineal window versus the magnetic resonance of the pelvis, for the evaluation of anatomical alterations in women with urinary incontinence.Especialista en Radiología e Imágenes Diagnósticas. Línea de Investigación: Imagen Corporal.57application/pdfspaMedicina y saludIncontinencia urinaria; Ultrasonido tridimensional; Resonancia magnética; Piso pélvico; Revisión sistemáticaUrinary Incontinence; Ultrasonography; Magnetic Resonance Imaging; Pelvic Floor DisordersRendimiento diagnóstico de la ecografía 3d comparada con resonancia magnética, para la evaluación de incontinencia urinaria. Revisión sistemáticaDiagnostic performance of 3d ultrasound compared to magnetic resonance, for the evaluation of urinary incontinence. Systematic reviewReporteinfo:eu-repo/semantics/reportinfo:eu-repo/semantics/acceptedVersionhttp://purl.org/coar/resource_type/c_93fcTexthttp://purl.org/redcol/resource_type/ARTCASOUniversidad Nacional de Colombia - Sede BogotáUniversidad Nacional de Colombia - Sede Bogotá1. Katya Carrillo G, Antonella Sanguineti M. Anatomía del piso pélvico. Rev Médica Clínica Las Condes [Internet]. 2013;24(2):185–9. Available from: http://www.elsevier.es/es-revista-revista-medica-clinica-las-condes-202-articulo-anatomia-del-piso-pelvico-S0716864013701482 2. Erdem N, Chu FM. Management of overactive bladder and urge urinary incontinence in the elderly patient. Am J Med. 2006 Mar;119(3 Suppl 1):29–36. 3. Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997 Apr;89(4):501–6. 4. Ebert AK, Falkert A, Brandl R, Hirschfelder H, Koller M, Rosch WH. Pelvic-floor imaging using three-dimensional ultrasonography and magnetic resonance imaging in the long term follow-up of the bladder-exstrophy-epispadias complex. BJU Int. 2009/07/09. 2010;105(2):248–53. 5. Allen RE, Hosker GL, Smith AR, Warrell DW. Pelvic floor damage and childbirth: a neurophysiological study. Br J Obstet Gynaecol. 1990 Sep;97(9):770–9. 6. Wijma J, Weis Potters AE, de Wolf BT, Tinga DJ, Aarnoudse JG. Anatomical and functional changes in the lower urinary tract during pregnancy. BJOG. 2001 Jul;108(7):726–32. 7. ACOG Practice Bulletin No. 155: Urinary Incontinence in Women. Obstet Gynecol. 2015 Nov;126(5):e66-81. 8. Nazir T, Khan Z, Barber HR. Urinary incontinence. Clin Obstet Gynecol. 1996 Dec;39(4):906–11. 9. Dietz HP, Hoyte LPJ, Steensma AB. Atlas of pelvic floor ultrasound. London: Springer; 2008. 10. Dietz HP, Gillespie AVL, Phadke P. Avulsion of the pubovisceral muscle associated with large vaginal tear after normal vaginal delivery at term. Aust New Zeal J Obstet Gynaecol [Internet]. 2007;47(4):341–4. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L47079565 11. Mundial A médica. Principios éticos para las investigaciones médicas en seres humanos. 1964. p. 1–9. 12. Ministerio de Salud. Republica de Colombia. Resolucion No 8430 de 1993 - 1. Por la cual se establecen las normas científicas, técnicas y administrativas para la investigación en salud. Colombia; 1993 p. 1–12. 13. Preparadas por el Consejo de Organizaciones internacionales de las Ciencias Médicas (CIOMS) en colaboración con la Organización Mundial de la Salud. Pautas éticas internacionales para la investigación biomédica en seres humanos. 2002. 14. Vergeldt TF, Notten KJ, Stoker J, Futterer JJ, Beets-Tan RG, Vliegen RF, et al. Comparison of translabial three-dimensional ultrasound with magnetic resonance imaging for measurement of levator hiatal biometry at rest. Ultrasound Obs Gynecol. 2015/07/17. 2016;47(5):636–41. 15. Stoker J, Bartram CI, Halligan S. Imaging of the posterior pelvic floor. Eur Radiol. 2002/04/18. 2002;12(4):779–88. 16. Dietz HP, Hyland G, Hay-Smith J. The assessment of levator trauma: A comparison between palpation and 4D pelvic floor ultrasound. Neurourol Urodyn [Internet]. 2006;25(5):424–7. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L44246635 17. Savoye-Collet C, Koning E, Dacher JN. Radiologic evaluation of pelvic floor disorders. Gastroenterol Clin North Am. 2008/09/17. 2008;37(3):553–67, viii. 18. Schwertner-Tiepelmann N, Thakar R, Sultan AH, Tunn R. Obstetric levator ani muscle injuries: current status. Ultrasound Obstet Gynecol [Internet]. 2012;39(4):372–83. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L365721148 19. Majida M, Braekken IH, Bø K, Benth JS, Engh ME. Validation of three-dimensional perineal ultrasound and magnetic resonance imaging measurements of the pubovisceral muscle at rest. Ultrasound Obstet Gynecol [Internet]. 2010;35(6):715–22. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L360232987 20. Cuicchi D, Lombardi R, Cariani S, Leuratti L, Lecce F, Cola B. 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