Emergency Department, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.
Acad Emerg Med. 2011 Aug;18(8):816-21. doi: 10.1111/j.1553-2712.2011.01130.x.
Automated bladder ultrasound (ABUS) devices are portable and designed to provide automated measurement of bladder volume. They are simple and require minimal training compared to conventional real-time ultrasound (RTUS). Their most common application in the acute pediatric setting is to assess bladder volumes prior to performing invasive urine collection such as suprapubic aspiration (SPA) in children younger than 2 years of age. However, data on ABUS in young children are limited. The aim of this study was to assess the repeatability and accuracy of one type of ABUS, the BladderScan, in measuring of bladder volume in children aged 0 to 24 months when compared with RTUS.
Healthy children aged 24 months and younger were scanned twice, 1 hour apart, using ABUS and RTUS. ABUS readings were performed by two senior pediatric emergency physicians who both completed three readings for each child. The measurements were repeated using a second ABUS machine in case of machine variability. RTUS measurements were performed by a pediatric sonographer who was blinded to the ABUS results. ABUS and RTUS measurements were compared by Bland-Altman analysis to determine the repeatability coefficient (repeatability) and the limits of clinical agreement (accuracy).
Bladder volume measurements were performed on 61 children aged 0 to 24 months (31 males; mean ± SD = age 11 ± 6.2 months; range = 0 to 24 months) using both the ABUS and the RTUS. There was wide variation between ABUS and RTUS measurements. The repeatability coefficient within ABUS readings was 20 mL. By Bland-Altman analysis, the 95% limits of agreement between ABUS and RTUS were -31 to +19 mL. ABUS also detected no values between 0 and 10 mL.
This study showed poor repeatability and accuracy in bladder volume measurements using BladderScan ABUS when compared to RTUS. The ABUS method does not appear to be a reliable method for assessing bladder volumes in children aged 0 to 24 months prior to bladder instrumentation.
自动膀胱超声（ABUS）设备便携且设计用于自动测量膀胱容量。与传统实时超声（RTUS）相比，它们操作简单，所需培训较少。在儿科急症环境中，其最常见的应用是在对 2 岁以下儿童进行有创尿液采集（如耻骨上抽吸术 [SPA]）之前评估膀胱容量。然而，ABUS 在幼儿中的数据有限。本研究的目的是评估一种 ABUS（BladderScan）在与 RTUS 相比测量 0 至 24 个月龄儿童膀胱容量时的可重复性和准确性。
使用 ABUS 和 RTUS 对 24 个月及以下的健康儿童进行两次扫描，两次扫描间隔 1 小时。两位资深儿科急诊医生对 ABUS 读数进行了三次测量，每位儿童各进行三次测量。如果存在机器差异，则使用第二台 ABUS 机器重复测量。RTUS 测量由一名对 ABUS 结果盲法的儿科超声医师进行。通过 Bland-Altman 分析比较 ABUS 和 RTUS 测量值，以确定重复性系数（可重复性）和临床一致的限值（准确性）。
使用 ABUS 和 RTUS 对 61 名 0 至 24 个月（31 名男性；平均 ± SD=年龄 11 ± 6.2 个月；范围 0 至 24 个月）的儿童进行了膀胱容量测量。ABUS 和 RTUS 测量值之间存在广泛差异。ABUS 读数的重复性系数为 20 mL。通过 Bland-Altman 分析，ABUS 和 RTUS 之间的 95%一致性限为 -31 至 +19 mL。ABUS 也未检测到 0 至 10 mL 之间的值。
与 RTUS 相比，本研究显示使用 BladderScan ABUS 进行膀胱容量测量的可重复性和准确性较差。ABUS 方法似乎不是评估 0 至 24 个月龄儿童膀胱仪器前膀胱容量的可靠方法。
