Hirahara Naoki, Ukimura Osamu, Ushijima So, Yamada Yasuhiro, Okihara Koji, Kawauchi Akihiro, Miki Tsuneharu
Department of Urology, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kyoto 602-8566, Japan.
J Ultrasound Med. 2006 Mar;25(3):307-13. doi: 10.7863/jum.2006.25.3.307.
The purpose of this study was to describe initial applications of 4-dimensional ultrasonography (4DUS) for visualizing dynamic change in 3-dimensional (3D) bladder shape as well as for analyzing intravesical volume and diameters during voiding.
In 15 healthy volunteers and 5 patients with lower urinary tract symptoms, 4DUS images of the bladder during voiding were obtained by transabdominal 4DUS and compared with the outcome of uroflowmetry. Changes of intravesical volume as well as diameters in axial, coronal, and sagittal planes were measured and analyzed in comparison with uroflow data.
Dynamic 3D visualization of the bladder shape was feasible in all 20 men. Multiplanar display of 4DUS showed dynamic 3D images of the bladder during voiding to be simultaneously visualized in the axial, coronal, and sagittal planes. The change and decrease rate in intravesical volume calculated by 4DUS data had significant correlation with the average flow rate (P = .02) and the maximum flow rate (P = .04), respectively. Among the 3 diameters, the change of coronal diameter was significantly most correlated with change of the intravesical volume (P < .0001). The change in coronal diameter, which was observed in patients with urinary disturbance, had a significant difference compared with those observed in control subjects (P = .01).
Monitoring of voiding with 4DUS was feasible in healthy men and patients with lower urinary tract symptoms. Four-dimensional ultrasonography has the potential to be a novel noninvasive urodynamic modality to visualize dynamically the lower urinary tract during voiding and to improve pathophysiologic understanding of voiding.
本研究的目的是描述四维超声（4DUS）在可视化三维（3D）膀胱形状动态变化以及分析排尿期间膀胱内体积和直径方面的初步应用。
对15名健康志愿者和5名下尿路症状患者，通过经腹4DUS获取排尿期间膀胱的4DUS图像，并与尿流率测定结果进行比较。测量并分析膀胱内体积以及轴向、冠状面和矢状面直径的变化，并与尿流数据进行比较。
在所有20名男性中，膀胱形状的动态3D可视化是可行的。4DUS的多平面显示显示排尿期间膀胱的动态3D图像可在轴向、冠状面和矢状面同时可视化。通过4DUS数据计算的膀胱内体积变化率和减少率分别与平均流速（P = 0.02）和最大流速（P = 0.04）具有显著相关性。在三个直径中，冠状面直径的变化与膀胱内体积的变化相关性最显著（P < 0.0001）。在尿路紊乱患者中观察到的冠状面直径变化与在对照组中观察到的变化有显著差异（P = 0.01）。
在健康男性和下尿路症状患者中，用4DUS监测排尿是可行的。四维超声有可能成为一种新型的非侵入性尿动力学检查方法，用于动态可视化排尿期间的下尿路，并增进对排尿病理生理学的理解。
