Noninvasive Evaluation of Bladder Wall Mechanical Properties as a Function of Filling Volume: Potential Application in Bladder Compliance Assessment.
Noninvasive Evaluation of Bladder Wall Mechanical Properties as a Function of Filling Volume: Potential Application in Bladder Compliance Assessment.
复制标题
DOI：
10.1371/journal.pone.0157818
复制
发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Fatemi M
中科院分区：
文献类型：
--
作者：
Nenadic I;Mynderse L;Husmann D;Mehrmohammadi M;Bayat M;Singh A;Denis M;Urban M;Alizad A;Fatemi M
我们提出了一种新的方法来监测膀胱壁的力学性能作为充盈量的函数，与膀胱顺应性评估的潜在应用。所提出的超声膀胱振动测量（UBV）方法使用超声波激发和跟踪兰姆波的膀胱壁，从它的机械性能是通过拟合测量到一个分析模型。特别感兴趣的是在不同的体积，我们假设，是类似于测量膀胱的顺应性特性的膀胱壁的剪切模量。使用了三种实验模型：1）离体猪模型，其中正常和异常（福尔马林硬化）膀胱接受UBV评价; 2）体内研究，以评价UBV对接受UDS的临床记录顺应性和非顺应性膀胱患者的性能; 3）非侵入性UBV方案，以评估三名健康志愿者的膀胱顺应性，使用口服水化和分次排尿。离体研究显示UBV参数与直接压力测量之间的高度相关性（R2 = 0.84-0.99）。在接受UDS逼尿肌压力-容积测量的2例顺应性和非顺应性膀胱患者（R2 = 0.89-0.99）中观察到类似的相关性。健康志愿者的UBV结果，没有导管插入术进行，是一个兼容的膀胱患者。UBV作为监测膀胱壁机械性能变化的方法的实用性通过与离体和体内患者研究中的压力测量的高度相关性来验证。UBV和UDS的高度相关性体内研究表明，UBV作为膀胱顺应性评估工具的潜力。对具有正常膀胱的健康志愿者的研究结果表明，UBV可以无创地进行。需要对更大的队列进行进一步研究，以充分验证UBV作为膀胱顺应性评估的临床工具的使用。
We propose a novel method to monitor bladder wall mechanical properties as a function of filling volume, with the potential application to bladder compliance assessment. The proposed ultrasound bladder vibrometry (UBV) method uses ultrasound to excite and track Lamb waves on the bladder wall from which its mechanical properties are derived by fitting measurements to an analytical model. Of particular interest is the shear modulus of bladder wall at different volumes, which we hypothesize, is similar to measuring the compliance characteristics of the bladder. Three experimental models were used: 1) an ex vivo porcine model where normal and aberrant (stiffened by formalin) bladders underwent evaluation by UBV; 2) an in vivo study to evaluate the performance of UBV on patients with clinically documented compliant and noncompliant bladders undergoing UDS; and 3) a noninvasive UBV protocol to assess bladder compliance using oral hydration and fractionated voiding on three healthy volunteers. The ex vivo studies showed a high correlation between the UBV parameters and direct pressure measurement (R2 = 0.84–0.99). A similar correlation was observed for 2 patients with compliant and noncompliant bladders (R2 = 0.89–0.99) undergoing UDS detrusor pressure-volume measurements. The results of UBV on healthy volunteers, performed without catheterization, were comparable to a compliant bladder patient. The utility of UBV as a method to monitor changes in bladder wall mechanical properties is validated by the high correlation with pressure measurements in ex vivo and in vivo patient studies. High correlation UBV and UDS in vivo studies demonstrated the potential of UBV as a bladder compliance assessment tool. Results of studies on healthy volunteers with normal bladders demonstrated that UBV could be performed noninvasively. Further studies on a larger cohort are needed to fully validate the use of UBV as a clinical tool for bladder compliance assessment.