采用 MRI 对下尿路进行全面无创分析。
Comprehensive non-invasive analysis of lower urinary tract anatomy using MRI.
机构信息
Departments of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, USA.
Departments of Mechanical Engineering, School of Medicine and Public Health, University of Wisconsin, 1513 University Avenue Rm 3035, Madison, WI, 53706, USA.
出版信息
Abdom Radiol (NY). 2021 Apr;46(4):1670-1676. doi: 10.1007/s00261-020-02808-9. Epub 2020 Oct 11.
PURPOSE
Anatomic changes that coincide with aging including benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) negatively impact quality of life. Use of MRI with its exquisite soft tissue contrast, full field-of-view capabilities, and lack of radiation is uniquely suited for quantifying specific lower urinary tract features and providing comprehensive measurements such as total bladder wall volume (BWV), bladder wall thickness (BWT), and prostate volume (PV). We present a technique for generating 3D anatomical renderings from MRI to perform quantitative analysis of lower urinary tract anatomy.
METHODS
T2-weighted fast-spin echo MRI of the pelvis in 117 subjects (59F;58 M) aged 30-69 (49.5 ± 11.3) without known lower urinary tract symptoms was retrospectively segmented using Materialise software. Virtual 3D models were used to measure BWV, BWT, and PV.
RESULTS
BWV increased significantly between the 30-39 and 60-69 year age group in women (p = 0.01), but not men (p = 0.32). BWV was higher in men than women aged 30-39 and 40-49 (p = 0.02, 0.05, respectively) ,but not 50-59 or 60-69 (p = 0.18, 0.16, respectively). BWT was thicker in men than women across all age groups. Regional differences in BWT were observed both between men and women and between opposing bladder wall halves (anterior/posterior, dome/base, left/right) within each sex in the 50-59 and 60-69 year groups. PV increased from the 30-39 to 60-69 year groups (p = 0.05). BWT was higher in subjects with enlarged prostates (> 40cm) (p = 0.05).
CONCLUSION
Virtual 3D MRI models of the lower urinary tract reliably quantify sex-specific and age-associated changes of the bladder wall and prostate.
目的
与衰老相关的解剖学变化，包括良性前列腺增生（BPH）和下尿路症状（LUTS），会降低生活质量。磁共振成像（MRI）具有出色的软组织对比度、全视野能力和无辐射的特点，非常适合量化特定的下尿路特征，并提供全面的测量，如膀胱壁总体积（BWV）、膀胱壁厚度（BWT）和前列腺体积（PV）。我们介绍了一种从 MRI 生成 3D 解剖图像的技术，用于对下尿路解剖结构进行定量分析。
方法
回顾性分析了 117 例年龄在 30-69 岁（49.5±11.3 岁）、无下尿路症状的受试者的盆腔 T2 加权快速自旋回波 MRI 数据，使用 Materialise 软件对其进行分割。使用虚拟 3D 模型来测量 BWV、BWT 和 PV。
结果
女性在 30-39 岁和 60-69 岁年龄组之间的 BWV 显著增加（p=0.01），而男性则没有（p=0.32）。在 30-39 岁和 40-49 岁年龄组，男性的 BWV 高于女性（p=0.02，0.05），但在 50-59 岁和 60-69 岁年龄组则没有（p=0.18，0.16）。BWT 在所有年龄组的男性中均大于女性。在 50-59 岁和 60-69 岁年龄组，男性和女性之间以及每个性别中膀胱壁的左右、前后、穹顶和基底之间都观察到了 BWT 的区域差异。PV 从 30-39 岁组增加到 60-69 岁组（p=0.05）。前列腺体积增大（>40cm）的患者 BWT 较高（p=0.05）。
结论
虚拟 3D MRI 模型可可靠地量化与性别和年龄相关的膀胱壁和前列腺变化。
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