Asfour Victoria, Gibbs Kayleigh, DaSilva Ana Sophia, Fernando Ruwan, Digesu Guiseppe Alessandro, Khullar Vik
St Mary's Hospital, Imperial College Healthcare NHS Trust, Paddington, W2 1NY, UK.
Int Urogynecol J. 2019 Sep;30(9):1575-1580. doi: 10.1007/s00192-018-3802-4. Epub 2018 Nov 28.
The aim was to validate ultrasound bladder wall thickness measurements. We scanned at three frequencies (5 MHz, 7 MHz and 9 MHz), using two techniques described in clinical practice and compared them with direct micrometre calliper measurements.
Bladder dome cadaver specimens were dissected from male and female cadavers. The direct micrometre calliper measurement under direct vision was used as the gold standard. We imaged using a Voluson E8 ultrasound scanner at three frequencies, using three probes: AB27D (2-7 MHz), RAB25D (2-5 MHz) and RIC50D (5-9 MHz). The specimens were scanned on two different occasions for intra-observer variability. A second operator, measured the samples again independently for the interobserver agreement. The specimens were gently placed onto a sheathed and gelled probe to avoid deformation. The method of scanning was the same for all the specimens, probes and operators.
Twenty-five bladder dome specimens were assessed. The correlation of the ultrasound measurement to the direct measurement improved at higher ultrasound frequencies. Measuring from the inside of the serosal hyperechogenicity also increased the accuracy correlation with the direct measurement for all the frequencies tested.
This is the first study validating BWT ultrasound measurements against cadaveric bladder wall calliper measurements. Technology and technique affect accuracy, which is important in clinical practice. The use of 5-MHz probes is not recommended. The most accurate measurement was obtained using high-frequency ultrasound, where the measurement did not include the serosal brightness. These data suggest that high-frequency ultrasound should be used to assess BWT.
目的是验证超声测量膀胱壁厚度的方法。我们使用临床实践中描述的两种技术，在三个频率（5兆赫、7兆赫和9兆赫）下进行扫描，并将其与直接用微米卡尺测量的结果进行比较。
从男性和女性尸体上解剖出膀胱顶部的尸体标本。直视下用微米卡尺直接测量作为金标准。我们使用Voluson E8超声扫描仪，通过三个探头在三个频率下成像：AB27D（2 - 7兆赫）、RAB25D（2 - 5兆赫）和RIC50D（5 - 9兆赫）。对标本进行两次不同的扫描以评估观察者内的变异性。另一位操作者再次独立测量样本以评估观察者间的一致性。将标本轻轻放在带护套且涂有凝胶的探头上以避免变形。所有标本、探头和操作者的扫描方法相同。
评估了25个膀胱顶部标本。在较高超声频率下，超声测量与直接测量的相关性有所提高。从浆膜高回声内部进行测量也提高了所有测试频率下与直接测量的准确性相关性。
这是第一项针对尸体膀胱壁卡尺测量验证膀胱壁厚度超声测量的研究。技术和方法会影响准确性，这在临床实践中很重要。不建议使用5兆赫的探头。使用高频超声且测量不包括浆膜亮度时可获得最准确的测量结果。这些数据表明应使用高频超声来评估膀胱壁厚度。
