Quantification of bladder wall biomechanics during urodynamics: A methodologic investigation using ultrasound
Quantification of bladder wall biomechanics during urodynamics: A methodologic investigation using ultrasound
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DOI：
10.1016/j.jbiomech.2017.07.028
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发表时间：
2017-08-16
影响因子：
2.4
通讯作者：
Speich, John E.
中科院分区：
文献类型：
--
作者：
Nagle, Anna S.;Klausner, Adam P.;Speich, John E.
膀胱过度活动通常以膀胱壁的生物力学变化为特征，但目前还没有确定的方法来测量这些变化。本研究的目的是发展一种新的方法，通过结合经腹超声成像来确定尿动力学过程中逼尿肌壁的生物力学参数。膀胱过动症（OAB）患者在充液时进行超声成像。填充率为每分钟膀胱容量的10%，由初始填充确定。每隔1分钟在正中矢状面和横切面采集经腹超声图像。利用图像数据和pve计算逼尿肌壁张力、应力和顺应性。从每个横截面图像中，测量腔和壁面积以及内周长。在矢状面和横向面上，壁张力计算为Pves *腔面积，壁应力计算为张力/壁面积，应变计算为10%容量时周长归一化的变化量。弹性模量计算为内侧外侧和颅尾方向的应力/应变。连续记录患者报告的饱腹感。来自五名OAB患者的数据显示，在所有测量量中，逼尿肌壁张力、体积和张力与持续膀胱感觉的相关性最高。本研究展示了如何通过将超声成像添加到标准尿动力学中来量化逼尿肌壁张力、应力、应变和弹性模量。这项技术可能有助于诊断和更好地了解OAB和其他膀胱疾病的生物力学。(C) 2017 Elsevier Ltd.版权所有。
Overactive bladder is often characterized by biomechanical changes in the bladder wall, but there is no established method to measure these changes in vivo. The goal of this study was to develop a novel method to determine detrusor wall biomechanical parameters during urodynamics through the incorporation of transabdominal ultrasound imaging. Individuals with overactive bladder (OAB) underwent ultrasound imaging during filling. The fill rate was 10% of the cystometric capacity per minute as determined by an initial fill. Transabdominal ultrasound images were captured in the midsagittal and transverse planes at 1 min intervals. Using image data and Pves, detrusor wall tension, stress, and compliance were calculated. From each cross sectional image, luminal and wall areas along with inner perimeters were measured. In the sagittal and transverse planes, wall tension was calculated as Pves * luminal area, wall stress as tension/wall area, and strain as the change in perimeter normalized to the perimeter at 10% capacity. Elastic modulus was calculated as stress/strain in the medial lateral and cranial-caudal directions. Patient-reported fullness sensation was continuously recorded. Data from five individuals with OAB showed that detrusor wall tension, volume, and strain had the highest correlations to continuous bladder sensation of all quantities measured. This study demonstrates how detrusor wall tension, stress, strain, and elastic modulus can be quantified by adding ultrasound imaging to standard urodynamics. This technique may be useful in diagnosing and better understanding the biomechanics involved in OAB and other bladder disorders. (C) 2017 Elsevier Ltd. All rights reserved.