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使用超声对膀胱顺应性进行无创评估:基于临床尿动力学研究的首次验证研究。

Non-invasive assessment of urinary bladder compliance using ultrasound: first validation study based on clinical urodynamic study.

作者信息

Zhang Xinyu, Husmann Douglas A, Mynderse Lance A, Alizad Azra, Fatemi Mostafa

机构信息

School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China.

Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine & Science, Rochester, MN, USA.

出版信息

Ann Transl Med. 2021 Apr;9(7):547. doi: 10.21037/atm-20-6900.

Abstract

BACKGROUND

This study aims to validate a recently introduced non-invasive method, ultrasound bladder vibrometry (UBV), for the assessment of detrusor compliance in patients with neurogenic bladders.

METHODS

The study was carried out on 79 adult patients with neurogenic bladders (60 male and 19 female). The UBV test was performed on each patient to measure the Lamb wave group velocity ( ) in the anterior bladder wall at every 50mL volume increment throughout the filling phase. Bladder compliance was assessed based on the trend of Lamb wave group velocity squared ( ) versus volume. A compliance index was defined to differentiate between the compliant and non-compliant bladders. Results of the UBV compliance assessment were validated using the readings of the corresponding urodynamic studies as the clinical gold standard.

RESULTS

The Patients' bladders were divided into non-compliant and compliant groups by an experienced urologist using the information in the urodynamic study (UDS) recordings. The compliance index defined on the basis of showed a significant difference (P<0.008) between the compliant and non-compliant groups. The areas under the receiver operating characteristic curve were 0.813, with 95% CI ranging from 0.709 to 0.892. Under the optimal criterion, the bladder was considered as non-compliant if the compliance index was less than 100 mL∙s/m, resulting in a sensitivity and specificity of 86.4% and 71.9%, respectively.

CONCLUSIONS

The results of this study demonstrate that UBV can be used as a non-invasive method for the determination of bladder compliance; thus, it can potentially serve as an alternative method to UDS for the appropriate patient groups.

摘要

背景

本研究旨在验证一种最近引入的非侵入性方法——超声膀胱振动测量法(UBV),用于评估神经源性膀胱患者的逼尿肌顺应性。

方法

对79例成年神经源性膀胱患者(60例男性和19例女性)进行了研究。在每个患者的膀胱充盈期,以50mL的体积增量对膀胱前壁进行UBV测试,测量兰姆波群速度( )。基于兰姆波群速度平方( )与体积的关系趋势评估膀胱顺应性。定义了一个顺应性指数来区分顺应性膀胱和非顺应性膀胱。以相应尿动力学研究的读数作为临床金标准,验证UBV顺应性评估的结果。

结果

由经验丰富的泌尿科医生根据尿动力学研究(UDS)记录中的信息,将患者的膀胱分为非顺应性组和顺应性组。基于 定义的顺应性指数在顺应性组和非顺应性组之间显示出显著差异(P<0.008)。受试者工作特征曲线下面积为0.813,95%置信区间为0.709至0.892。在最佳标准下,如果顺应性指数小于100 mL∙s/m,则膀胱被视为非顺应性,其敏感性和特异性分别为86.4%和71.9%。

结论

本研究结果表明,UBV可作为一种非侵入性方法用于测定膀胱顺应性;因此,对于合适的患者群体,它有可能成为尿动力学检查的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f87/8105840/8753b957f1e5/atm-09-07-547-f1.jpg

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