Non-invasive assessment of urinary bladder compliance using ultrasound: first validation study based on clinical urodynamic study.
Non-invasive assessment of urinary bladder compliance using ultrasound: first validation study based on clinical urodynamic study.
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DOI：
10.21037/atm-20-6900
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发表时间：
2021-04
影响因子：
--
通讯作者：
Fatemi M
中科院分区：
文献类型：
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作者：
Zhang X;Husmann DA;Mynderse LA;Alizad A;Fatemi M
本研究旨在验证最近引入的一种非侵入性方法，超声膀胱振动仪（UBV），用于评估神经源性膀胱患者的逼尿肌顺应性。研究对象为79例神经源性膀胱患者（男性60例，女性19例）。对每位患者进行UBV测试，以测量在整个充血期每增加50mL体积时膀胱前壁的兰姆波群速度（cg）。膀胱顺应性根据兰姆波群速度平方（cg2）与体积的趋势进行评估。定义了一个顺应指数来区分顺应和不顺应膀胱。使用相应尿动力学研究的读数作为临床金标准，验证了UBV依从性评估的结果。由经验丰富的泌尿科医生根据尿动力学研究（UDS）记录的信息将患者的膀胱分为非顺应组和顺应组。以cg2为基础定义的依从性指标，依从组与非依从组差异有统计学意义（P<0.008）。受试者工作特征曲线下面积为0.813,95% CI范围为0.709 ~ 0.892。在最优标准下，合规性指数小于100 mL∙s2/m2为膀胱不合规性，敏感性为86.4%，特异性为71.9%。本研究结果表明，uvb可以作为一种非侵入性的方法来测定膀胱顺应性；因此，对于适当的患者群体，它可以作为UDS的替代方法。
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. 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 (cg) 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 (cg2) 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. 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 cg2 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∙s2/m2, resulting in a sensitivity and specificity of 86.4% and 71.9%, respectively. 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.