Department of Obstetrics and Gynecology, Taipei Medical University, Taipei, Taiwan.
Ultrasound Obstet Gynecol. 2011 Aug;38(2):210-6. doi: 10.1002/uog.9003.
To evaluate the intra- and interobserver reliability of a new method of assessing resting and dynamic urethral compression after midurethral tape procedures using three- and four-dimensional (3D and 4D) ultrasound.
Thirty-one women who had undergone transobturator midurethral tape procedures at Cathay General Hospital were enrolled in the study and 4D ultrasound was performed pre- and postoperatively. Preoperative ultrasound assessment included measurement of the urethral central echolucent area (UCEA) in the axial plane. Postoperative ultrasound assessment included measurement of the tape-urethral distance (TUD) in the sagittal plane as well as UCEA and tape angle in the axial plane (ATA). The TUD was measured at the upper end (TUDu), central point (TUDc) and lower end (TUDl) of the tape. All pre- and postoperative ultrasound assessments were performed in women at rest, on maximum straining and during strong coughing. 4D ultrasound volume datasets were stored digitally and analyzed offline by two independent investigators blinded to clinical data and to each others' measurements. Intra- and interobserver reliability were evaluated using the intraclass correlation coefficient (ICC).
There were significant reductions in TUDc, TUDl and UCEA during increased intra-abdominal pressure. ICC values for the measurement of TUD at rest, on straining and during coughing demonstrated very good reliability. ICC values for the pre- and postoperative measurement of UCEA at rest, on straining and during coughing demonstrated good to very good reliability. ICC values for the measurement of ATA at rest, on straining and during coughing demonstrated fair to good reliability.
4D ultrasound can be used to obtain measurements with good reliability in the assessment of urethral compression.
评估一种新的方法评估经闭孔尿道中段吊带术后静息和动态尿道压迫的的内-观察者间可靠性，该方法使用三维和四维（3D 和 4D）超声。
本研究纳入了 31 名在国泰医院接受经闭孔尿道中段吊带术的女性患者，并在术前和术后进行了 4D 超声检查。术前超声评估包括在轴平面上测量尿道中央透明区（UCEA）。术后超声评估包括在矢状平面上测量吊带-尿道距离（TUD）以及在轴平面上测量 UCEA 和吊带角度（ATA）。TUD 在吊带的上端（TUDu）、中心点（TUDc）和下端（TUDl）进行测量。所有术前和术后的超声评估均在女性静息、最大用力和剧烈咳嗽时进行。4D 超声体积数据集以数字方式存储，并由两位独立的观察者在不知道临床数据和彼此测量值的情况下离线进行分析。使用组内相关系数（ICC）评估内-观察者间和观察者间的可靠性。
在增加腹内压时，TUDc、TUDl 和 UCEA 显著减小。在静息、用力和咳嗽时测量 TUD 的 ICC 值显示出非常好的可靠性。在静息、用力和咳嗽时测量 UCEA 的术前和术后 ICC 值显示出良好到非常好的可靠性。在静息、用力和咳嗽时测量 ATA 的 ICC 值显示出良好到非常好的可靠性。
4D 超声可用于评估尿道压迫时获得具有良好可靠性的测量值。
