三维容积超声定量儿童膀胱容积的准确性研究

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。

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

ObjectiveTo investigate the accuracy of three-dimensional ultrasound volumetric measurements for children＇s bladder. MethodsThe 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. ResultsChildren＇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). ConclusionsThree-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.