The Value Of Acoustic Radiation Force Impulse In Diagnosis Of Female Bladder Neck Obstruction

Objective：To discuss Virtual Touch tissue Quantification(VTQ) which is onetechnique of Acoustic Radiation Force Impulse (ARFI) could be the scanning methodsin the diagnosis of female bladder neck obstruction united with perineal ultrasound andthree dimensional ultrasound. Comparing the Shear wave velocity(SWV) which is themeasurement index of VTQ in normal adults’ bladder neck and that in female bladderneck obstruction to evaluate whether it can detect the elasticity and hardness ofbladder neck pathological changes. Whether VTQ can be used as a noninvasive andeffective means for assessing the degree of bladder neck obstruction united with2D and3D or not.Methods：Perineal ultrasound was used to detect the bladder neck and levator aniof36patients with bladder neck obstruction, and30cases of normal adult incase-control study, observing its2d and3d ultrasonic characteristics. We measured thethickness and shear wave velocity (SWV) of bladder neck’s anterior lip and posteriorlip.The thickness and shear wave velocity (SWV) changes of the levator ani betweentwo groups were observed respectively at resting state and contracting state.Thedistance from the resting bladder neck to the valsalva state and the bladder neckmobility, urinary bladder rotated angle, urinary bladder post angle. They also weremeasured respectively at resting state and valsalva state.. All of the data were analyzedby Statistical Package for the Social Sciences (SPSS)17.0software．Results：Perineal ultrasound in two-dimensional can clearly show all the bladderneck shape,thickness of the client,whether there is a space-occupying lesions,foreignbodies, etc. By perineal three-dimensional ultrasound it can be more intuitive, image,fully show the pelvic floor integral form, thickening of bladder neck rings when theenlargement and urinary tract foreign bodies The anterior lip according to the SWV2.11m/s was the best cutoff point of the strain ratio for differentiating the bladder neck obstruction and normal.The posterior lip according to the SWV2.06m/s was the bestcutoff point. There was a significant difference in the thickness and SWV of the bladderneck between the volunteers and the bladder neck obstruction patients.There was asignificant difference in the thickness and SWV of levator ani between the volunteersand the bladder neck obstruction patients. There was significant associativity betweenthe thickness and SWV of the bladder neck and bladder neck obstructionThere was asignificant difference in SWV of levator ani between resting state and valsalva state inthe same case. There were no significant differences in the bladder neck mobility,urinary bladder rotated angle, urinary bladder post angle which could be used todifferential diagnosis with urinary incontinence,between normal and bladder neckobstruction, There was no associativity between the bladder neck mobility, urinarybladder rotated angle, urinary bladder post angle and bladder neck obstructionConclusion：Perineal ultrasound can clearly display and measure female urethralstructure, three-dimensional ultrasound can provide more abundant female urethra andthree dimensional space information about the structure of the pelvic floor. The VTQtechnology of Acoustic Radiation Force Impulse can quantitatively reflect the bladderneck hardness change in texture, for clinical diagnosis of female bladder neckobstruction and etiology research provides a quantitative indicators. ARFI united withperineal ultrasound can be displayed important clinical values.