Bladder dysfunction: diagnosis with dynamic US.
OBJECTIVE
To evaluate the role of dynamic ultrasonography (US) in the diagnosis of bladder dysfunction and to compare dynamic US with urodynamic study, which is considered to be the standard in the diagnosis of bladder dysfunction.


METHODS
Images from 71 pairs of examinations in 63 patients (median age, 7.9 years; range 1.0-17.4 years) were included in the study. After the child consumed adequate fluids in an appropriate environment, natural filling of the bladder occurred, and dynamic US was used to evaluate detrusor activity, determine capacity of the bladder, and estimate residual urine volume. A urodynamic study was performed in every patient within 6 months of dynamic US and under the same treatment conditions. The paired Student t test was used to compare the maximal cystometric capacity values obtained with the two examinations. Analysis of validity was performed with the calculation of sensitivity, specificity, positive and negative predictive values, and their respective 95% confidence limits.


RESULTS
The bladder capacity was not significantly different between dynamic US and urodynamic study (P =.12). Analysis of validity for the determination of the presence of clinically substantial residual urine showed 97.7% sensitivity and 100% specificity for dynamic US. The sensitivity and specificity of dynamic US in the detection of involuntary detrusor contraction were 93.0% and 88.9%, respectively. In the analysis of involuntary detrusor contraction with urine leakage, dynamic US showed sensitivity of 100% and specificity of 97.8%.


CONCLUSIONS
Dynamic US is a sensitive method for the diagnosis of bladder dysfunction.
Filgueiras
Maria F Tereza F
MF
Radiology Unit of Hospital das Clinical, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. terezafilgueiras@terra.com.br
Lima
Eleonora M
EM
Sanchez
Talitah M
TM
Goulart
Eugenio M A
EM
Menezes
Alexandre C
AC
Pires
Cleidismar R
CR
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D014463:Ultrasonography; D001745:Urinary Bladder Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D014563:Urodynamics