Reliability of color Doppler ultrasound urodynamics in the evaluation of bladder outlet obstruction.
OBJECTIVE
To analyze the intrarater and interrater reliability of a newly developed noninvasive urodynamic technique based on color Doppler ultrasound for the evaluation of bladder outlet obstruction. We previously demonstrated the feasibility of this new technique.


METHODS
Color Doppler ultrasound urodynamic evaluations were performed on 31 men with and without bladder outlet obstruction. An ultrasound image-directed Doppler system with a 3.75-MHz probe operated by a remote control robotic manipulator was used to obtain color scale data using the transperineal approach in men during voiding. We measured the flow velocities in the distal prostatic (V1) and membranous urethra (V2) and used them to obtain the velocity ratio (VR = V1/V2). Combining this information with simultaneous uroflowmetry, the functional cross-sectional area of the distal prostatic urethra (A1) was calculated. These parameters were independently reinterpreted by an inexperienced investigator using the color image data stored in a personal computer. The intrarater and interrater reliability for VR were assessed using a classification based on cutoff values previously shown to indicate the presence or absence of obstruction.


RESULTS
The retest correlation using Spearman's rho for VR in terms of intrarater and interrater reliability was 0.95 and 0.57, respectively; that for A1 was 0.97 and 0.64, respectively. Using a VR of less than 1.1 (to indicate the absence of obstruction) and a VR greater than 1.6 (to indicate the presence of obstruction) for classification, intrarater and interrater agreement occurred in 93.6% to 96.8% and 77.4% to 83. 9% of cases, respectively.


CONCLUSIONS
The color Doppler ultrasound urodynamic technique for noninvasive evaluation of bladder outlet obstruction can be performed with reasonable reliability.
Ding
Y Y
YY
Department of Geriatric Medicine, Tan Tock Seng Hospital, Tan Tock Seng, Singapore.
Ozawa
H
H
Yokoyama
T
T
Nasu
Y
Y
Chancellor
M B
MB
Kumon
H
H
D000328:Adult; D000368:Aged; D003936:Diagnosis, Computer-Assisted; D004231:Diuresis / Q000502:physiology; D005069:Evaluation Studies as Topic; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D018615:Ultrasonography, Doppler, Color / Q000592:standards* / Q000706:statistics & numerical data; D001748:Urinary Bladder Neck Obstruction / Q000175:diagnosis*; D014556:Urine / Q000502:physiology; D014563:Urodynamics / Q000502:physiology*