Contrast-Enhanced Urodynamic Vector Projectile Imaging (CE-UroVPI) for Urethral Voiding Visualization: Principles and Phantom Studies
Contrast-Enhanced Urodynamic Vector Projectile Imaging (CE-UroVPI) for Urethral Voiding Visualization: Principles and Phantom Studies
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DOI：
10.1016/j.urology.2020.03.005
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发表时间：
2020-06-01
期刊：
影响因子：
2.1
通讯作者：
Yu, Alfred C. H.
中科院分区：
文献类型：
--
作者：
Ishii, Takuro;Nahas, Hassan;Yu, Alfred C. H.
目的设计一种新的尿流动力学成像框架，可以提供时间分辨的可视化尿流和尿道变形的初始阶段voiding.MATERIALS和方法对比增强的尿流动力学矢量射弹成像（CE-UroVPI）设计使用的原则，高帧率超声，微泡造影剂，和流动矢量映射。使用研究用超声扫描仪（5 MHz频率）和市售造影剂（USTRIM Prime）实施CE-UroVPI。使用2个定制设计的可变形尿道模型（健康模型和良性前列腺增生（BPH）疾病模型）评价了CE-UroVPI的性能，这2个模型分别模拟了有和无机械性梗阻的尿路中的尿动力学。结果CE-UroVPI使用1，250 fps的帧速率（相当于0.8ms的时间分辨率），有效地描述了排尿起始阶段的瞬态尿动力学事件。在BPH梗阻的尿道的尿动力学中观察到异常的时空特征。具体而言，在阻塞部位的上游，在排泄的前100 ms中观察到流速的瞬时激增。在梗阻部位的下游，出现了以射流和漩涡形式出现的复杂的泌尿系疾病。这些异常没有发现在健康的urture.CONCLUSION CE UroVPI是第一个成像框架，可以可视化复杂的尿动力学在整个排尿事件，包括其启动阶段。这种新的工具可能被用来潜在地获得新的洞察尿道形态动力学因素和下尿路症状之间的因果关系。(C)2020爱思唯尔公司
OBJECTIVE To devise a new urodynamic imaging framework that can provide time-resolved visualization of urinary flow and urethral deformation during the initiation phase of voiding.MATERIALS AND METHODS Contrast-enhanced urodynamic vector projectile imaging (CE-UroVPI) was devised using the principles of high-frame rate ultrasound, microbubble contrast agents, and flow vector mapping. CE-UroVPI was implemented using a research-purpose ultrasound scanner (5 MHz frequency) and commercial contrast agents (USphere Prime). The performance of CE-UroVPI was evaluated using 2 custom-designed deformable urethra phantoms - a healthy model and a diseased model with benign prostatic hyperplasia (BPH) - that respectively simulate urodynamics in the urinary tract with and without mechanical obstruction. The corresponding spatiotemporal urodynamics were investigated and analyzed.RESULTS Using a frame rate of 1,250 fps that corresponds to 0.8 ms time resolution, CE-UroVPI effectively depicted the transient urodynamic events during the initiation phase of voiding. Anomalous spatiotemporal characteristics were observed in the urodynamics of the BPH-obstructed urethra. Specifically, upstream from the obstruction site, a transient surge in flow speed was observed in the first 100 ms of voiding. Also, downstream from the obstruction site, complex urodnyamics had emerged in the forms of flow jet and vortices. These anomalies were not found in the healthy urethra.CONCLUSION CE-UroVPI is the first imaging framework that can visualize complex urodynamics over an entire voiding episode including its initiation phase. This new tool may be used to potentially gain new insight into the causal relationships between urethral morphokinetic factors and lower urinary tract symptoms. (C) 2020 Elsevier Inc.