ORIGINAL ARTICLE   

Il Giornale Italiano di Radiologia Medica 2019 Novembre-Dicembre;6(6):519-22

DOI: 10.23736/S2283-8376.19.00222-5

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

The diagnostic value of ultrasound elastography in acute cystitis

Işıl YURDAIŞIK ¹, Hüseyin A. SOLGUN ² ✉

¹ Department of Radiology, Istinye University Medical Faculty, Istinye University Medical Park, Gaziosmanpasa Hospital, Istanbul, Turkey; ² Department of Pediatrics, Istinye University Medical Faculty, Istinye University Medical Park, Gaziosmanpasa Hospital, Istanbul, Turkey

BACKGROUND: Ultrasound (US) elastography evaluation of the bladder wall in patients diagnosed with acute cystitis by complete urinalysis and urine culture.
METHODS: A total of 60 patients (37 children, 23 adults), who were referred to Department of Radiology for urinary system US examination from March to October 2017 were included to the study. Two independent radiologists who were unaware of the patients’ laboratory diagnostic information have evaluated all patients with urinary system US examination (ACUSON Sequoia™ Ultrasound System; Siemens Healthcare). After that bladder wall thickness was measured with a convex US probe (5C1) in B mode grayscale while the patient was in supine position, US Elastography two-dimensional shear-wave elastography (2D-SWE) examination was performed towards bladder wall. The correlation between the presence of leukocytes and erythrocytes in urine and US-elastography measurement value of bladder wall, as well as the correlation between urine culture and US-elastography measurement value of bladder wall were evaluated. Moreover, the correlation between bladder wall thickness and US elastography were also evaluated.
RESULTS: A high positive correlation was found between the bladder wall thickness measurement performed with B mode grayscale and US elastography results (P<0.001, Pearson correlation was r=0.85 for children and r=0.68 for adults). There was a positive correlation between leukocyte and erythrocyte presence in urine and US elastography measurements taken from bladder wall for the patients who had a confirmed diagnosis of acute cystitis via complete urinalysis and the difference was much more significant in pediatric group (r=0.72 and 0.45 for children and r=0.65 and 0.46 for adults, respectively). However, there was no statistically significant correlation detected between urine culture results and bladder wall US elastography measurement results (P>0.05). Inter-observer agreement was highly correlated (Gwets AC2=0.93 and 0.96, respectively).
CONCLUSIONS: US elastography examination, additionally performed to B-mode grayscale US examination of the bladder with acute cystitis diagnosis is a supplementary screening method particularly in pediatric patients.

KEY WORDS: Elasticity imaging techniques; Ultrasonography; Cystitis; Early detection of cancer