膀胱超声弹性振动成像技术和尿动力学检查评估膀胱顺应性的临床评价
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摘要
目的评估膀胱超声弹性振动成像技术(UBV)和尿动力学检查(UDS)测量膀胱顺应性的相关性。方法本研究共入组40例神经源性膀胱患者,对所有患者同时进行UDS和UBV检查,分别记录不同膀胱灌注体积下的逼尿肌压力(Pdet)和膀胱壁力学参数,并比较二者的相关性。结果群速度平方和弹性模量作为UBV测量得到的膀胱壁力学参数分别与UDS测量的Pdet具有较高的相关性,中位相关系数分别为0.86(95%CI:0.74～0.94)和0.84(95%CI:0.66～0.92),群速度平方和弹性模量与Pdet的相关指数显著高于0.5。结论 UBV可密切监测神经源性膀胱患者在UDS检查过程中不同膀胱容量下的膀胱壁力学参数改变,可作为一种非侵入性评估技术用于膀胱顺应性的检测。
Objective To evaluate the correlation of bladder compliance measured by ultrasound bladder vibrometry(UBV)and urodynamic study(UDS).Methods A total of 40 patients with neurogenic bladder were enrolled.UDS and UBV examinations were performed on all patients simultaneously.The detrusor pressure(Pdet)and mechanical parameters of bladder wall were recorded under different bladder perfusion volume,and the correlation between the two methods was analyzed.Results Bladder wall mechanical properties obtained by UBV such as group velocity squared and elasticity showed high correlations with Pdet measured by UDS,with the median correlation coefficients of 0.86(95%CI:0.74-0.94)and0.84(95%CI:0.66-0.92)respectively.The correlation of group velocity squared and elasticity with Pdet were both significantly higher than0.5.Conclusion UBV can closely monitor the changes of bladder wall mechanical parameters in patients with neurogenic bladder under different bladder volumes during UDS examination,which can be used as a non-invasive evaluation technique for bladder compliance testing.
Objective To evaluate the correlation of bladder compliance measured by ultrasound bladder vibrometry(UBV)and urodynamic study(UDS).Methods A total of 40 patients with neurogenic bladder were enrolled.UDS and UBV examinations were performed on all patients simultaneously.The detrusor pressure(Pdet)and mechanical parameters of bladder wall were recorded under different bladder perfusion volume,and the correlation between the two methods was analyzed.Results Bladder wall mechanical properties obtained by UBV such as group velocity squared and elasticity showed high correlations with Pdet measured by UDS,with the median correlation coefficients of 0.86(95%CI:0.74-0.94)and0.84(95%CI:0.66-0.92)respectively.The correlation of group velocity squared and elasticity with Pdet were both significantly higher than0.5.Conclusion UBV can closely monitor the changes of bladder wall mechanical parameters in patients with neurogenic bladder under different bladder volumes during UDS examination,which can be used as a non-invasive evaluation technique for bladder compliance testing.
引文
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[16]ZHOU H,ZHENG YF.Anefficient quadrature demodulator for medical ultrasound imaging[J].Front Inform Tech Electr Engineer,2015,16(4):301-310.
[17]周秀芳.超声弹性成像技术的临床应用[J].中国医药指南,2014,30(12):367-368.
[18]YING H,DA L,LUO J,et al.Quantitative assessment of bladder neck compliance by using transvaginal real-time elastography of women[J].Ultras Med Biol,2013,39(10):1727-1734.
[19]NENADIC I,MEHRMOHAMMADI M,URBAN MW,et al.In vivo patient measurements of bladder elasticity using Ultrasound Bladder Vibrometry(UBV)[J].Conf Proc IEEE Eng Med Biol Soc,2013:113-116.
[20]AKKUS Z,BAYAT M,CHEONG M,et al.Fully automated and robust tracking of transient waves in structured anatomies using dynamic programming[J].Ultras Med Biol,2016,42(10):2504-2512.
[21]NENADIC I,MYNDERSE L,HUSMANN D,et al.Noninvasive evaluation of bladder wall mechanical properties as a function of filling volume:potential application in bladder compliance assessment[J].PLoS One,2016,11(6):e0157818.
[22]文建国,朱文.动态尿动力学检查的临床应用进展[J].中华泌尿外科杂志,2013,34(4):317-320.
[23]FRAQUELLI M,RIGAMONTI C,CASAZZA G,et al.Reproducibility of transient elastography in the evaluation of liver fibrosis in patients with chronic liver disease[J].Gut,2007,56(7):968-973.
[2]HIDAS G,LEE HJ,BAHORIC A,et al.Aerosol transfer of bladder urothelial and smooth muscle cells onto demucosalized colonic segments for bladder augmentation:In vivo,long term,and functional pilot study[J].J Pediatr Urol,2015,11(5):260.e1-6.
[3]JOHNSON EU,SINGH G.Long-term outcomes of urinary tract reconstruction in patients with neurogenic urinary tract dysfunction[J].Indian J Urol,2013,29(4):328-337.
[4]杜岳峰,张琳,康党鹏,等.239例下尿路排尿功能障碍患者影像尿动力学特点分析[J].第三军医大学学报,2015,37(6):510-514.
[5]WYNDAELE JJ,GAMMIE A,BRUSCHINI H,et al.Bladder compliance what does it represent:can we measure it,and is it clinically relevant?[J].Neurourol Urodyn,2011,30(5):714-722.
[6]SERATI M,SALVATORE S,CATTONI E,et al.Ultrasound measurement of bladder wall thickness in different forms of detrusor overactivity[J].Int Urogynecol J,2010,21(11):1405-1411.
[7]TANAKA H,MATSUDA M,MORIYA K,et al.Ultrasonographic measurement of bladder wall thickness as a risk factor for upper urinary tract deterioration in children with myelodysplasia[J].J Urol,2008,180(1):312-316.
[8]LEKSKULCHAI O,DIETZ HP.Detrusor wall thickness as a test for detrusor overactivity in women[J].Ultra Obstet Gynecol,2008,32(4):535-539.
[9]FARAG FF,HEESAKKERS JP.Non-invasive techniques in the diagnosis of bladder storage disorders[J].Neurourol Urodyn,2011,30(8):1422-1428.
[10]DENIS M,GREGORY A,BAYAT M,et al.Correlating tumor stiffness with immunohistochemical subtypes of breast cancers:prognostic value of comb-push ultrasound shear elastography for differentiating luminal subtypes[J].PLoS One,2016,11(10):e0165003.
[11]王挺,王培龙.超声弹性成像技术及临床应用研究进展[J].国际泌尿系统杂志,2013,33(6):828-831.
[12]BAYAT M,DENIS M,GREGORY A,et al.Diagnostic features of quantitative comb-push shear elastography for breast lesion differentiation[J].PLoS One,2017,12(3):e0172801.
[13]NENADIC IZ,QIANG B,URBAN MW,et al.Ultrasound bladder vibrometry method for measuring viscoelasticity of the bladder wall[J].Phys Med Biol,2013,58(8):2675-2695.
[14]那彦群,孙颖浩,叶章群,等.中国泌尿外科疾病诊断治疗指南(2014版)[M].北京:人民卫生出版社,2014:267-329.
[15]TANTER M,FINK M.Ultrafast imaging in biomedical ultrasound[J].IEEE Trans Ultrason Ferroelectr Freq Control,2014,61(1):102-119.
[16]ZHOU H,ZHENG YF.Anefficient quadrature demodulator for medical ultrasound imaging[J].Front Inform Tech Electr Engineer,2015,16(4):301-310.
[17]周秀芳.超声弹性成像技术的临床应用[J].中国医药指南,2014,30(12):367-368.
[18]YING H,DA L,LUO J,et al.Quantitative assessment of bladder neck compliance by using transvaginal real-time elastography of women[J].Ultras Med Biol,2013,39(10):1727-1734.
[19]NENADIC I,MEHRMOHAMMADI M,URBAN MW,et al.In vivo patient measurements of bladder elasticity using Ultrasound Bladder Vibrometry(UBV)[J].Conf Proc IEEE Eng Med Biol Soc,2013:113-116.
[20]AKKUS Z,BAYAT M,CHEONG M,et al.Fully automated and robust tracking of transient waves in structured anatomies using dynamic programming[J].Ultras Med Biol,2016,42(10):2504-2512.
[21]NENADIC I,MYNDERSE L,HUSMANN D,et al.Noninvasive evaluation of bladder wall mechanical properties as a function of filling volume:potential application in bladder compliance assessment[J].PLoS One,2016,11(6):e0157818.
[22]文建国,朱文.动态尿动力学检查的临床应用进展[J].中华泌尿外科杂志,2013,34(4):317-320.
[23]FRAQUELLI M,RIGAMONTI C,CASAZZA G,et al.Reproducibility of transient elastography in the evaluation of liver fibrosis in patients with chronic liver disease[J].Gut,2007,56(7):968-973.