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Bladder Dysfunction: Diagnosis with Dynamic US¹

¹ From the Radiology Unit of Hospital das Clinical (M.F.T.F.F.), Pediatric Nephrology Unit (E.M.L., T.M.S.), Department of Pediatrics (E.M.A.G.), and Urology Unit (A.C.M., C.R.P.), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. From the 2001 RSNA scientific assembly. Received November 25, 2001; revision requested February 1, 2002; revision received May 7; accepted October 21. Address correspondence to M.F.T.F.F., Rúa Nicarágua 48, Apt 201, Belo Horizonte, Minas Gerais, Brazil (e-mail: terezafilgueiras@terra.com.br).

PURPOSE: 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.

MATERIALS AND 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%.

CONCLUSION: Dynamic US is a sensitive method for the diagnosis of bladder dysfunction.

© RSNA, 2003

Index terms: Bladder, abnormalities, 83.831, 83.834 • Bladder, US, 83.12981 • Children, genitourinary system • Ultrasound (US), comparative studies, 83.12981, 83.1233 • Urine, incontinence

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