A Novel Endoluminal Ultrasound Imaging Technique to Determine Urethral Luminal Cross-Sectional Area.
A Novel Endoluminal Ultrasound Imaging Technique to Determine Urethral Luminal Cross-Sectional Area.
复制标题
一种确定尿道管腔横截面积的新型腔内超声成像技术。
DOI：
10.1089/end.2018.0554
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发表时间：
2018
影响因子：
2.7
通讯作者：
Rajasekaran,MahadevanRaj
中科院分区：
文献类型：
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作者：
Bhargava,Raag;Yu,Hosong;Chilukuri,AbinavT;Kim,Jaesoo;Yuk,Seung-Mo;Lee,Seung-Ryeol;Fuller,ThomasW;Buckley,JillC;Bhargava,Valmik;Rajasekaran,MahadevanRaj
简介与目的：逆行尿道造影（RUG）和排尿膀胱造影（VCUG）是目前诊断尿道狭窄和确定狭窄位置的金标准成像技术。然而，RUG和VCUG有许多限制。这些技术需要暴露在电离辐射中，质量取决于操作者和患者，尿道导尿有中等程度的侵入性，由于患者的体位低估了狭窄的长度，可能会产生假影。发展新的不需要电离辐射的成像方式来准确评估尿道狭窄的存在、位置、长度和管腔横截面积（CSA）将具有重要的价值。本研究的目的是发展一种新的腔内超声（ELUS）成像技术，可以准确定量尿道狭窄。方法：采用电致尿道狭窄兔（n= 5），采用ELUS技术进行尿道造影。经尿道引入3.2F 40 MHz超声（US）探头，注入US造影剂。当导管以恒定速度向后拉取以获取断层图像时，记录图像。整个尿道长度的腔内CSA使用定制的方法计算，并在我们的实验室验证。结果：量化实验狭窄发生前后尿道腔内CSA，包括狭窄长度。观察者内部和观察者之间的可变性（r= 0.99）非常好。结论：ELUS作为一种定量检测健康尿道腔及狭窄CSA的方法是可行的。相对于目前的方法，一种非电离成像方式能够更好地描述CSA、长度、位置和未受累的尿道CSA，是一项重大的改进。
Introduction and Objectives:Retrograde urethrogram (RUG) and voiding cystourethrogram (VCUG) are currently the gold standard imaging technique for diagnosis of urethral stricture and determination of stricture location. However, RUG and VCUG have multiple limitations. These techniques require exposure to ionizing radiation, the quality is operator and patient dependent, there is a moderate degree of invasiveness with urethral catheterization, can have artifacts because of patient positioning that underestimates stricture length. The development of novel imaging modalities without ionizing radiation to accurately evaluate the presence, location, length, and lumen cross-sectional area (CSA) of the urethral stricture would be of great value. The objective of this study was to develop a novel endoluminal ultrasound (ELUS) imaging technique that permits the accurate quantitation of urethral stricture.Methods:Urethral strictures were created in rabbits (n= 5) by electrocautery and an ELUS technique was developed for subsequent luminal imaging. A 3.2F 40 MHz ultrasound (US) probe was introduced transurethrally and infused with US contrast agent. Images were recorded as the catheter was pulled back at a constant speed to acquire tomographic images. Lumen CSA over the entire urethral length was calculated using a custom methodology and validated in our laboratory.Results:Urethral luminal CSA over the entire length of urethra before and after experimental stricture development was quantified including the length of stenosis. Intra- and interobserver variability (r= 0.99 for both) was excellent.Conclusions:Feasibility of ELUS as a quantitative technique to determine healthy urethral lumen and stricture CSA was demonstrated. The translational potential for a nonionizing imaging modality to better describe CSA, length, location, and uninvolved urethral CSA of the stricture is a significant improvement over current methodology.