Can Stress Urinary Incontinence Be Predicted by Ultrasound?
Can Stress Urinary Incontinence Be Predicted by Ultrasound?
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超声波可以预测压力性尿失禁吗？
DOI：
10.2214/ajr.18.20893
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发表时间：
2019-11-01
影响因子：
5
通讯作者：
Zhang, Xinling
中科院分区：
文献类型：
--
作者：
Xiao, Ting;Chen, Ying;Zhang, Xinling
OBJECTIVE.本研究的目的是确定经唇实时三维超声预测压力性尿失禁（SUI）的价值。主题和方法。从2012年12月至2016年8月，前瞻性招募了由泌尿科医生通过尿动力学诊断为SUI或无SUI的女性。所有受试者均在一家机构接受经唇实时3D超声检查。由一名放射科医生离线分析体积数据，该放射科医生对诊断不知情，并评估最大Valsalva动作时的膀胱颈位置、最大Valsalva动作时的提肌裂孔面积、膀胱颈下降和尿道旋转角度。使用Fisher线性判别分析分析两个、三个和四个参数的组合。构建ROC曲线以确定四个参数和所有参数组合预测SUI的最佳截止值。结果共纳入321名SUI女性（平均[± SD]年龄，35 ± 11岁）和90名无SUI女性（平均年龄，31 ± 8岁）。只有337名女性被纳入最终研究，以消除年龄的混淆因素。最大Valsalva动作时膀胱颈位置、最大Valsalva动作时上睑提肌裂孔面积、膀胱颈下降和尿道旋转角作为SUI预测参数的临界值分别为1 mm、19 cm 2、24 mm和45°。对于所有参数组合，阴性预测值均大于90%，尽管没有组合的灵敏度高于70%。当包括三个或四个参数时，特异性约为95%。组合的阳性预测值范围为49.2%至84.8%。结论经唇实时3D超声不足以预测SUI，但它可以用于识别没有这种情况的女性。
OBJECTIVE. The purpose of this study is to determine the value of translabial real-time 3D ultrasound for predicting stress urinary incontinence (SUI). SUBJECTS AND METHODS. From December 2012 to August 2016, women with or without SUI diagnosed by urologists via urodynamics were prospectively recruited. All subjects underwent translabial real-time 3D ultrasound at one institution. Volume data were analyzed offline by a radiologist who was blinded to the diagnosis and who evaluated the bladder neck position on maximal Valsalva maneuver, the levator hiatus area on maximum Valsalva maneuver, bladder neck descent, and the urethral rotation angle. Combinations of two, three, and four parameters were analyzed using Fisher linear discriminant analysis. ROC curves were constructed to determine the optimal cutoff values of the four parameters and all combinations of parameters to predict SUI. RESULTS. A total of 321 women with SUI (mean [± SD] age, 35 ± 11 years) and 90 women without SUI (mean age, 31 ± 8 years) were included. Only 337 women were included in the final study, to eliminate the confounder of age. The cutoff values for the bladder neck position on maximal Valsalva maneuver, the levator hiatus area on maximum Valsalva maneuver, bladder neck descent, and the urethral rotation angle as parameters predicting SUI were 1 mm, 19 cm2, 24 mm, and 45°, respectively. For all combinations of parameters, the negative predictive values were more than 90%, although none of the combinations had a sensitivity higher than 70%. The specificities were approximately 95% when three or four parameters were included. The positive predictive value of the combinations ranged from 49.2% to 84.8%. CONCLUSION. Translabial real-time 3D ultrasound is insufficient for predicting SUI, but it can be used to identify women without the condition.