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体感诱发电位作为治疗难治性膀胱过度活动症儿童脊柱病变诊断的筛查工具。

Somatosensory evoked potentials as a screening tool for diagnosis of spinal pathologies in children with treatment refractory overactive bladder.

作者信息

Thomas David Terence, Yener Sevim, Kalyoncu Aybegum, Uluc Kayihan, Bayri Yasar, Dagcinar Adnan, Dagli Tolga, Tugtepe Halil

机构信息

Department of Pediatric Surgery, Maltepe University Faculty of Medicine, Istanbul, Turkey.

Department of Pediatric Surgery, Marmara University School of Medicine, Istanbul, Turkey.

出版信息

Childs Nerv Syst. 2017 Aug;33(8):1327-1333. doi: 10.1007/s00381-017-3393-2. Epub 2017 Mar 24.

Abstract

PURPOSE

To evaluate the usefulness of somatosensory evoked potential as a screening tool for spinal pathologies in patients with treatment refractory overactive bladder.

METHODS

This prospective study was performed between January 2011 and January 2014. Children >5 years old with treatment refractory overactive bladder were enrolled after exclusion of anatomical and neurological causes of incontinence. All patients underwent urodynamic studies, spinal MRI, and somatosensory evoked potential (SEP). Sensitivity, specificity, PPV, and NPV were calculated for SEP.

RESULTS

Thirty-one children (average age 8.3 ± 2.9 years) were included in the study. SEP was abnormal in 13 (41.9%), and MRI was abnormal in 8 (25.8%) patients. SEP was found to have a sensitivity of 87.5%, a specificity of 73.9%, positive predictive value of 53.85%, and negative predictive value (NPV) of 94.4%.

CONCLUSION

In patients with treatment refractory OAB, SEP is an important tool for the screening of tethered cord/spinal pathologies. Our results suggest that a child with a normal SEP study in this group of patients may not require further investigation with MRI.

摘要

目的

评估体感诱发电位作为难治性膀胱过度活动症患者脊柱病变筛查工具的实用性。

方法

这项前瞻性研究于2011年1月至2014年1月进行。纳入5岁以上难治性膀胱过度活动症患儿,排除尿失禁的解剖学和神经学原因。所有患者均接受尿动力学检查、脊柱磁共振成像(MRI)和体感诱发电位(SEP)检查。计算SEP的敏感性、特异性、阳性预测值和阴性预测值。

结果

31名儿童(平均年龄8.3±2.9岁)纳入研究。13名(41.9%)患者SEP异常,8名(25.8%)患者MRI异常。SEP的敏感性为87.5%,特异性为73.9%,阳性预测值为53.85%,阴性预测值为94.4%。

结论

在难治性膀胱过度活动症患者中,SEP是筛查脊髓拴系/脊柱病变的重要工具。我们的结果表明,该组患者中SEP检查正常的儿童可能无需进一步进行MRI检查。

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