Development of non invasive lower urinary tract function test using ultrasound Doppler imaging

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1. Flow velocity of urine can be measured by ultrasound sonographyIt had been believed to be impossible to measure the intraurethral flow velocity by ultrasonography, since urine does not contain any particles reflecting ultrasound. We hypothesized that according to Bernoulli's principle a decrease of flow pressure caused by an accelerated urinary flow produces micro bubbles associated with cavitation responsible for Doppler signals. This hypothesis was confirmed by A simultaneous detection of microtubbles specific to cavitation with a charged-coupled device (CCD) camera and Doppler signals with an ultrasound scanner was conducted.2. Velocity related parameters are proved to be useful for evaluating bladder outlet obstruction(BOO).Functional cross-sectional area at prostatic urethra (UFA=UR/UV: UV: velocity at prostatic urethra, UR: flow rate) and velocity ratio (VR=V1/V2: V1: velocity at prostatic urethra, V2: velocity at sphincteric urethra) were proved to be practical parameters far evaluating BOO. "'e investigated the best flow velocity related parameter, which allowed prediction of improvement of lower urinary tract symptoms (LUTS) after α 1-blocker treatment.. The patients with higher V2 might be poor responders against alpha-blocker treatment.3. Custom made software has been improved.In order to reduce analytic time and apply the system not only for BOO but also for whole voiding dysfunction, analytic software has been improved.(1) Automatic plotting of ROI (region of interest) ~(2) Indication of corrected angle(3) Automatic graphic indication of previously proposed parameters (Al, A2 and VR)(4) Automatic graphic indication of new parameters to analyze bladder function4. Velocity-flow plots.Two dimensional graph plots between velocity related parameter and flow rate in whole voiding has been performed. A delay of initial velocity signal may be useful to diagnose voiding dysfunction