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Published online before print April 3, 2003, 10.1148/radiol.2272011872
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Bladder Dysfunction: Diagnosis with Dynamic US1

Maria F. Tereza F. Filgueiras, MD, MSc, Eleonora M. Lima, MD, PhD, Talitah M. Sanchez, MD, Eugênio M. A. Goulart, MD, PhD, Alexandre C. Menezes, MD and Cleidismar R. Pires, MD

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).



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  		Figure 1a. (a) Longitudinal US images of the bladder show relaxed detrusor (left) and contracted detrusor (right). Simultaneous alteration of the shape of the bladder and the appearance of the bladder wall took place, with an increase in the anteroposterior diameter, a decrease in the longitudinal diameter, and a serrated appearance of the wall (arrow). (b) Transverse US images of the bladder show contracted detrusor (left) and relaxed detrusor (right). The bladder changed in shape from quadrangular to rounded, and the wall appears serrated (arrows).

 


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  		Figure 1b. (a) Longitudinal US images of the bladder show relaxed detrusor (left) and contracted detrusor (right). Simultaneous alteration of the shape of the bladder and the appearance of the bladder wall took place, with an increase in the anteroposterior diameter, a decrease in the longitudinal diameter, and a serrated appearance of the wall (arrow). (b) Transverse US images of the bladder show contracted detrusor (left) and relaxed detrusor (right). The bladder changed in shape from quadrangular to rounded, and the wall appears serrated (arrows).

 


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  		Figure 2a. Longitudinal US images of the bladder. (a) A diverticulum (arrow) is seen in the posterolateral wall of the bladder. (b) Observe the filling of the diverticulum (arrow) during the contraction of the detrusor.

 


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  		Figure 2b. Longitudinal US images of the bladder. (a) A diverticulum (arrow) is seen in the posterolateral wall of the bladder. (b) Observe the filling of the diverticulum (arrow) during the contraction of the detrusor.

 


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  		Figure 3. Longitudinal US images of the bladder. Arrow shows the position of the bladder neck. Left image shows cephalic position of the bladder neck during the contraction of the pelvic floor muscle. Right image shows caudal position of the bladder neck when the pelvic floor muscle is relaxed.

 


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  		Figure 4a. Images show alterations that indicate increased bladder pressure. All images were obtained during the same examination. (a) Longitudinal images of the left kidney show a dilated collecting system (arrow). (b) Bladder features small diverticula. During dynamic US, it is possible to observe the difficulty of emptying the ureter. Arrow indicates the left ureter. (c) Immediately after voiding of the bladder, the collecting system of the kidney is almost empty (arrow).

 


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  		Figure 4b. Images show alterations that indicate increased bladder pressure. All images were obtained during the same examination. (a) Longitudinal images of the left kidney show a dilated collecting system (arrow). (b) Bladder features small diverticula. During dynamic US, it is possible to observe the difficulty of emptying the ureter. Arrow indicates the left ureter. (c) Immediately after voiding of the bladder, the collecting system of the kidney is almost empty (arrow).

 


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  		Figure 4c. Images show alterations that indicate increased bladder pressure. All images were obtained during the same examination. (a) Longitudinal images of the left kidney show a dilated collecting system (arrow). (b) Bladder features small diverticula. During dynamic US, it is possible to observe the difficulty of emptying the ureter. Arrow indicates the left ureter. (c) Immediately after voiding of the bladder, the collecting system of the kidney is almost empty (arrow).

 




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