Role of imaging in urogynaecology

Rahmanou, Philip; Chaliha, Charlotte; Khullar, Vikram

doi:10.1111/j.1471-0528.2004.00462.x

Cited by 11 publications

(6 citation statements)

References 69 publications

(81 reference statements)

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“…We think this is due to the anisotropy of the bladder neck. When the patient was asked to perform a Valsalva action, the structure of the middle region of the urethra could be clearly displayed on the 2D ultrasound image …”

Section: Discussionmentioning

confidence: 99%

Value of Real‐Time Shear Wave Elastography Versus Acoustic Radiation Force Impulse Imaging in the Diagnosis of Female Bladder Neck Obstruction

Qian

Jiang

et al. 2019

J of Ultrasound Medicine

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Objective-To investigate the application value of shear wave elastography (SWE) and acoustic radiation force impulse imaging (ARFI) in the diagnosis of female bladder neck obstruction (FBNO), we compared the advantages of these 2 methods to provide a more accurate reference for clinical work.Methods-From April 2016 to February 2018, 27 patients who were diagnosed with FBNO by cystoscopy and/or urine dynamics testing were selected for the study, together with 24 healthy adults in a case-control study at Liaoning Province People's Hospital. We collected general information from 27 patients with FBNO, and using transperineal 2-dimensional ultrasound detection, shear wave elastography (SWE) and ARFI were used, respectively, to detect the Young's modulus and shear wave velocity (SWV) of the bladder necks. Cystoscopy results were considered to be the gold standard, and receiver operating characteristic (ROC) curves were drawn for ARFI, SWE, and the combined diagnosis of the two. The efficacy of the diagnosis was determined by comparing the areas under the ROC curves and calculating the sensitivity, specificity, and accuracy.Results-The areas under the ROC curve for the Q-box mean and max value detected by SWE for FBNO patients were 88.4% and 89.9%, respectively, and the sensitivity, specificity, and accuracy were 81.5%, 79.2%, and 80.4%, respectively. The area under the ROC curve detected by ARFI for FBNO patients was 93.7%, and the sensitivity, specificity, and accuracy were 88.9%, 79.2%, and 84.3%, respectively. The sensitivity, specificity, and accuracy of the combined detection of ARFI and SWE were 92.5%, 87.5%, and 90.2%, respectively. The best diagnostic cutoff point of the SWV or the Q-box mean and max value of SWE in FBNO obtained with the ROC curve was SWV = 2.38 m/s (sensitivity, 71.4%; specificity, 82.5%), Q-box mean = 20.2 kPa, Q-box max = 39.8 kPa (sensitivity, 67.5%; specificity, 76.2%). The average shear wave velocity of ARFI, Q-box mean, and Q-box max value of SWE in the control group were 1.89 AE 0.35 m/s, 15.3 AE 3.6 kPa, and 29.2 AE 8.7 kPa, respectively. In the FBNO group, these values were 2.81 AE 0.63) m/s, 27.2 AE 8.6 kPa, and 51.2 AE 12.3 kPa, respectively. The differences were statistically significant (P < .05).Conclusion-The value of the ARFI in the diagnosis of FBNO is a little greater than that of SWE in terms of sensitivity and accuracy, and the combined detection of ARFI and SWE performs better than ARFI or SWE employed separately.Abbreviations 2D, 2-dimensional; ARFI, acoustic radiation force impulse imaging; FBNO, female bladder neck obstruction; P det , detrusor pressure; Q max , maximum urine flow rate; ROC, receiver operating characteristic; ROI, region of interest; SWE, shear wave elastography; SWV, shear wave velocity.

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Section: Discussionmentioning

confidence: 99%

Value of Real‐Time Shear Wave Elastography Versus Acoustic Radiation Force Impulse Imaging in the Diagnosis of Female Bladder Neck Obstruction

Qian

Jiang

et al. 2019

J of Ultrasound Medicine

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“…Linearly organized tissues lead to specular reflection of the ultrasound waves back into the probe, this generates an echogenic image (whiteness) on ultrasound. Disorganized tissues scatter the ultrasound waves in all directions, leading to a hypoechogenic image (black) in ultrasound . See Figures A,B.…”

Section: Discussionmentioning

confidence: 99%

Levator Ani avulsion: The histological composition of this site. A cadaveric study

Silva

Asfour

Digesu

et al. 2018

Neurourology and Urodynamics

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Introduction The sonographic appearance of a levator muscle “avulsion” representing the literal detachment of the pubovisceral muscle (PVM) enthesis has been contested. The nature of the levator ani “avulsion” is still not fully understood. It is known, that the tensile strength of a tendon is dependent on collagen with increased synthesis of collagen occurring in tissue with increased mechanical load levels. This study aims to perform a quantitative histological evaluation of the PVM enthesis with or without the imaging finding of levator ani “avulsion” to determine if there is a difference in the proportion of muscle and collagen. Method Three‐dimensional translabial ultrasound for PVM “avulsion” was performed on cadavers using a GE Voluson I with a 5‐9 MHz electronic probe. Cadavers were meticulously dissected to identify the presence or absence of an anatomical avulsion. The PVM enthesis was excised for further histopathological processing and treated with three different colorations. Quantitative analysis using ImageJ software was conducted to compare tissue composition in samples with or without sonographic “avulsion.” All stages were performed by two separate investigators blinded to each other's results. The results were analyzed using SPSS v24, IBM. Results Twenty‐three PVM enthesis with histological staining were procured. Ultrasonographic “avulsions” were seen in 5/23 PVM enthesis. No anatomical avulsions were seen. There was no difference in the overall muscle or collagen content (Kruskal‐Wallis, P = 0.864). The mean organized skeletal muscle content was 23% in the sonographic “avulsion” group versus 62% in the no “avulsion” group (Kruskall‐Walis, P = 0.02). “Avulsions” were associated with a disorganized appearance at histology. Conclusion The tissue composition relating to the proportion of muscle and collagen was not significantly different in specimens with or without sonographic “avulsions.” However, morphological differences were observed in the organization of the muscle fibres, which requires further evaluation.

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“…In terms of the absence of an echo in the middle area of the urethra on perineal 2‐dimensional sonography, it can be considered an anisotropic artifact. Because the direction of the urethra is parallel to that of the acoustic beam, the central structure of urethra can be clearly shown after the Valsalva maneuver 32 …”

Section: Discussionmentioning

confidence: 99%

Application of Acoustic Radiation Force Impulse Imaging for Diagnosis of Female Bladder Neck Obstruction

Qian

Jiang

et al. 2016

J of Ultrasound Medicine

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The bladder neck's anatomic structure can be observed visually by perineal sonography. Virtual Touch tissue quantification on acoustic radiation force impulse imaging can quantitatively reflect the bladder neck stiffness and change in texture. It could provide a quantitative indicator for clinical diagnosis of female bladder neck obstruction and etiology research and display important clinical values.

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Role of imaging in urogynaecology

Cited by 11 publications

References 69 publications

Value of Real‐Time Shear Wave Elastography Versus Acoustic Radiation Force Impulse Imaging in the Diagnosis of Female Bladder Neck Obstruction

Value of Real‐Time Shear Wave Elastography Versus Acoustic Radiation Force Impulse Imaging in the Diagnosis of Female Bladder Neck Obstruction

Levator Ani avulsion: The histological composition of this site. A cadaveric study

Application of Acoustic Radiation Force Impulse Imaging for Diagnosis of Female Bladder Neck Obstruction

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