三维容积超声定量儿童膀胱容积的准确性研究

doi:10.3877/cma.j.issn.1672-6448.2015.02.016

目的

探讨三维容积超声定量儿童膀胱容积的准确性。

方法

2013年2~6月在深圳市儿童医院行超声检查的儿童238例，行膀胱三维容积超声成像，其中男性106例、女性132例；根据体表面积分组：0.36~0.60?m²（27例）、0.61~0.78?m²（66例）、0.79~0.89?m²（52例）、0.90~1.05?m²（33例）、1.06~1.20?m²（30例）、1.21~1.78?m²（30例）。分别采用Voluson E8、iU22，测量膀胱三维容积，与实际排出尿量比较，分析膀胱容积与实际排出尿量的相关性。

结果

儿童膀胱三维容积大小随体表面积增大而增大（F=33.53，P<0.05），与体表面积呈正相关（r=0.679，P<0.05）；各体表面积组经三维容积超声所测得的膀胱容积与实际尿量比较，均小于实际尿量[（47.80±30.33）?ml vs（82.24±49.63）?ml、（77.20±39.72）?ml vs（139.98±79.03）?ml、（95.96±50.79）?ml vs （175.96±101.70）?ml、（117.46±54.17）?ml vs （206.62±86.22）?ml、（145.53±73.60）?ml vs （253.33±135.09）ml、（220.27±110.34）ml vs （327.42±165.45）?ml]，差异均有统计学意义（t=3.19、5.53、5.08、4.49、3.84、3.00，P均<0.05）；但与实际尿量呈正相关（r=0.881，P<0.05）。各体表面积组儿童二维超声模拟椭圆体法计算的膀胱容积也低于实际尿量[（50.38±36.94）?ml vs （82.24±49.63）?ml、（86.77±62.34）?ml vs （139.98±79.03）?ml、（102.69±60.21）?ml vs （175.96±101.70）?ml、（107.94±55.14）?ml vs （206.62±86.22）?ml、（145.31±66.01）?ml vs （253.33±135.09）?ml、（222.77±132.59）?ml vs （327.42±165.45）?ml]，差异均有统计学意义（t=3.03、4.01、4.47、4.95、3.94、2.75，P均<0.05）；两者呈正相关（r=0.326，P<0.05）。

结论

三维容积超声定量儿童膀胱容积可行，临床应用时应考虑到儿童生长的因素，可结合回归方程更为准确定量儿童膀胱容积。

关键词: 三维超声, 膀胱, 容积, 儿童

Objective

To investigate the accuracy of three-dimensional ultrasound volumetric measurements for children＇s bladder.

Methods

The bladder volumes of 238 children aged 9 months to 16 years (male: 106; female: 132) in Shenzhen Children＇s Hospital underwent real-time three-dimensional ultrasound for volume measurements. These cases were divided into six groups according to the body surface area: (0.36~0.60) m² (27 cases), (0.61~0.78) m² (66 cases), (0.79~0.89) m² (52 cases), (0.90~1.05) m² (33 cases), (1.06~1.20) m² (30 cases) and (1.21~1.78) m² (30 cases). The bladder volume measured by GE Voluson E8 and Philips iU22 were compared with the actual volumes of discharge urine. The relation between bladder volume measurements and the actual volume of discharge urine was analyzed.

Results

Children＇s bladder volume increasesd with the body surface area (F=33.53, P<0.05) and showed positive correlations with the body surface area (r=0.679, P<0.05). Compared with the actual volume of discharge urine, each group＇s bladder volume measurements obtained by three-dimensional ultrasound were lower and the results were as follows: [(47.80±30.33) ml vs (82.24±49.63) ml, (77.20±39.72) ml vs (139.98±79.03) ml, (95.96±50.79) ml vs (175.96±101.70) ml, (117.46±54.17) ml vs (206.62±86.22) ml, (145.53±73.60) ml vs (253.33±135.09) ml and (220.27±110.34) ml vs (327.42±165.45) ml]. The differences between children＇s bladder volume measurements and the actual volume of discharge urine were statistically significant (t=3.19, 5.53, 5.08, 4.49, 3.84 and 3.00, all P<0.05), but children＇s bladder volume showed positive correlations with the actual urine volume (r=0.881, P<0.05). The bladder volume measurements by spheroid formula based on two-dimensional ultrasound are lower than the actual volume of discharge urine, and the results were as follows: [(50.38±36.94) ml vs (82.24±49.63) ml, (86.77±62.34) ml vs (139.98±79.03) ml, (102.69±60.21) ml vs (175.96±101.70) ml, (107.94±55.14) ml vs (206.62±86.22) ml, (145.31±66.01) ml vs (253.33±135.09) ml and (222.77±132.59) ml vs (327.42±165.45) ml]. The differences were statistically significant (t=3.03, 4.01, 4.47, 4.95, 3.94 and 2.75, all P<0.05), but children＇s bladder volume showed positive correlations with actual urine volume (r=0.326, P<0.05).

Conclusions

Three-dimensional ultrasound volumetric measurements for children＇s bladder is feasible and in clinical application, the factors of children's growth should be take into account. Combing regression equation, children＇s bladder volume can be more accurately quantified.

Key words: Three-dimensional ultrasound, Bladder, Volume, Children

图2 膀胱三维容积图，模拟膀胱形态类似圆锥体

表1 不同体表面积儿童三维容积超声、二维模拟法膀胱容积与实际尿量的结果及其比较（ml）

分组（体表面积，m²）	例数	V_A	V_B	V_R
0.36~0.60	27	47.80±30.33^a	50.38±36.94^b	82.24±49.63
0.61~0.78	66	77.20±39.72^a	86.77±62.34^b	139.98±79.03
0.79~0.89	52	95.96±50.79^a	102.69±60.21^b	175.96±101.70
0.90~1.05	33	117.46±54.17^a	107.94±55.14^b	206.62±86.22
1.06~1.20	30	145.53±73.6^a	145.31±66.01^b	253.33±135.09
1.21~1.78	30	220.27±110.34^a	222.77±132.59^b	327.42±165.45

表1 不同体表面积儿童三维容积超声、二维模拟法膀胱容积与实际尿量的结果及其比较（ml）

分组（体表面积，m²）	例数	V_A	V_B	V_R
0.36~0.60	27	47.80±30.33^a	50.38±36.94^b	82.24±49.63
0.61~0.78	66	77.20±39.72^a	86.77±62.34^b	139.98±79.03
0.79~0.89	52	95.96±50.79^a	102.69±60.21^b	175.96±101.70
0.90~1.05	33	117.46±54.17^a	107.94±55.14^b	206.62±86.22
1.06~1.20	30	145.53±73.6^a	145.31±66.01^b	253.33±135.09
1.21~1.78	30	220.27±110.34^a	222.77±132.59^b	327.42±165.45

图3 儿童膀胱容积与实际尿量的相关趋势线图，显示膀胱容积与实际尿量呈正相关

图4 同一观察者不同时间观察儿童膀胱三维容积的Bland-Altman分析，表明观察者内部重复性良好

图5 同观察者之间观察儿童膀胱三维容积图的Bland-Altman分析，表明观察者之间一致性较好

1	Suwanrath C, Suntharasaj T, Sirapatanapipat H, et al. Three-dimensional ultrasonographic bladder volume measurement: reliability of the virtual organ computer-aided analysis technique using different rotation steps[J]. J Ultrasound Med, 2009, 28(7): 847-854.
2	Liang CC, Wei TY, Chang SD, et al. Bladder volume determination: two -dimensional versus three-dimensional transvaginal ultrasound[J]. Taiwan J Obstet Gynecol, 2009, 48(3): 258-261.
3	杨素国，章建全，杨钰. 三维超声重建法体积计算准确性的实验评价[J]. 医学影像学杂志, 2012, 22(11): 1951-1955.
4	许娜，夏焙，周蔚, 等. 儿童超声心动图测量指标正常参考值的建立及临床意义[J/CD]. 中华医学超声杂志:电子版, 2012, 9(1) : 40-49.
5	Cheong KB, Leung KY, Chan HY, et al. Comparison of inter- and intraobserver agreement between three types of fetal volume measurement technique (XI VOCAL, VOCAL and multiplanar)[J]. Ultrasound Obstet Gynecol, 2009, 33(3): 287-294.
6	顾胜利，陈亚青，蒋珺, 等. 对比三维超声VOCAL技术与CT评估兔肝脏体积[J]. Chin J Med Imaging Technol, 2013, 29(1): 11-14.
7	Peralta CF, Kazan-Tannus JF, Bunduki V, et al. Evaluation of the agreement between 3-dimensional ultrasonography and magnetic resonance imaging for fetal lung volume measurement[J]. J Ultrasound Med, 2006, 25 (4): 461-467.
8	项飞翔，陈汉荣，黄幼珍, 等. 实时三维超声测量膀胱容积的初步探讨[J]. 中国临床医学影像杂志, 2004, 15(5): 269-272.
9	Barreto EQ, Milani HJ, Araujo Junior E, et al. Reliability and validity of in vitro volume calculations by 3-dimensional ultrasonography using the multiplanar, virtual organ computer-aided analysis (VOCAL), and extended imaging VOCAL methods[J]. J Ultrasound Med, 2010, 29(5): 767-774.
10	张剑，胡建群，夏泽. 三维超声测量不规则物体体积的准确性[J]. 中国医学影像技术, 2009, 25(6): 1099-1102.
11	Peixoto-Filho FM, Sa RA, Lopes LM, et al. Three-dimensional ultrasound fetal urinary bladder volume measurement: reliability of rotational (VOCALTM) technique using different steps of rotation[J]. Arch Gynecol Obstet, 2007, 276(4): 345-349.
12	周蔚，夏焙，冯霞, 等. 三维超声检测儿童肾脏体积正常参考值及其临床意义[J]. 临床超声医学杂志, 2012, 14(11): 752-755.

[1]	张璇, 马宇童, 苗玉倩, 张云, 吴士文, 党晓楚, 陈颖颖, 钟兆明, 王雪娟, 胡淼, 孙岩峰, 马秀珠, 吕发勤, 寇海燕. 超声对Duchenne肌营养不良儿童膈肌功能的评价[J]. 中华医学超声杂志（电子版）, 2023, 20(10): 1068-1073.
[2]	张宝富, 俞劲, 叶菁菁, 俞建根, 马晓辉, 刘喜旺. 先天性原发隔异位型肺静脉异位引流的超声心动图诊断[J]. 中华医学超声杂志（电子版）, 2023, 20(10): 1074-1080.
[3]	韩丹, 王婷, 肖欢, 朱丽容, 陈镜宇, 唐毅. 超声造影与增强CT对儿童肝脏良恶性病变诊断价值的对比分析[J]. 中华医学超声杂志（电子版）, 2023, 20(09): 939-944.
[4]	刘婷婷, 林妍冰, 汪珊, 陈幕荣, 唐子鉴, 代东伶, 夏焙. 超声衰减参数成像评价儿童代谢相关脂肪性肝病的价值[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 787-794.
[5]	周钰菡, 肖欢, 唐毅, 杨春江, 周娟, 朱丽容, 徐娟, 牟芳婷. 超声对儿童髋关节暂时性滑膜炎的诊断价值[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 795-800.
[6]	刘丹妮, 敖梦, 冉海涛, 李世玉, 秦芳. 三维超声心动图及二维斑点追踪成像对持续性心房颤动复律后双心房逆向重构的评估[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 827-835.
[7]	顾志波, 郝林, 陆明, 陈建刚. 光动力纳米载体联合si-P3H4治疗膀胱癌的初步探索[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(06): 633-641.
[8]	汪洋, 李志鹏, 王可兵. 上尿路尿路上皮癌术后预防性膀胱灌注化疗的研究进展[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(06): 649-652.
[9]	左解鹏, 周典晟, 王健, 刘文博, 吴长利, 田大伟. 局麻下利用软性膀胱镜联合铥激光治疗麻醉高风险膀胱肿瘤患者的经验[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(06): 563-569.
[10]	王东, 刘晓辉, 韩镇远. 吸引鞘辅助处理膀胱结石合并精囊多发结石一例报告[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(06): 647-648.
[11]	吕垒, 冯啸, 何凯明, 曾凯宁, 杨卿, 吕海金, 易慧敏, 易述红, 杨扬, 傅斌生. 改良金氏评分在儿童肝豆状核变性急性肝衰竭肝移植手术时机评估中价值并文献复习[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 661-668.
[12]	蓝冰, 王怀明, 王辉, 马波. 局部晚期结肠癌膀胱浸润的研究进展[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 505-511.
[13]	刘笑笑, 张小杉, 刘群, 马岚, 段莎莎, 施依璐, 张敏洁, 王雅晳. 中国学龄前儿童先天性心脏病流行病学研究进展[J]. 中华临床医师杂志(电子版), 2023, 17(9): 1021-1024.
[14]	邓世栋, 刘凌志, 郭大勇, 王超, 黄忠欣, 张晖辉. 沉默SNHG1基因对膀胱癌细胞增殖、凋亡、迁移和铁死亡的影响[J]. 中华临床医师杂志(电子版), 2023, 17(07): 804-811.
[15]	李静, 张玲玲, 邢伟. 兴趣诱导理念用于小儿手术麻醉诱导前的价值及其对家属满意度的影响[J]. 中华临床医师杂志(电子版), 2023, 17(07): 812-817.

阅读次数

全文

摘要

选择文件类型/文献管理软件名称

选择包含的内容

Accuracy of three-dimensional ultrasound volumetric measurements for bladder of children

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

Accuracy of three-dimensional ultrasound volumetric measurements for bladder of children