Application value of hydrogen proton magnetic resonance spectroscopy analysis technology in the diagnosis of female overactive bladder
-
摘要: 目的 探讨利用氢质子磁共振波谱(hydrogen proton magnetic resonance spectroscopy，1H-MRS)分析技术检测女性膀胱过度活动症(overactive bladder，OAB)患者与对照组之间膀胱壁胆碱(choline，Cho)水平的差异并探讨其潜在诊断价值。方法 选择2022年7月—2023年8月于合肥市第二人民医院诊断为OAB的女性患者(OAB组)和同时期与患者年龄、体重指数(BMI)相匹配的女性健康志愿者(对照组)。所有受试者均进行了2次膀胱多体素1H-MRS扫描，分别为初始尿意产生时(膀胱充盈期)及排空膀胱后(膀胱空虚期)。通过Siemens Skyra 3.0T磁共振成像系统自带后处理软件计算出膀胱前壁、后壁、两侧壁Cho/肌酸(creatine，Cr)比值，并采用t检验进行组间和组内比较。结果 本研究OAB组纳入23例，对照组纳入17例。2组进行组间比较，OAB组膀胱充盈期Cho含量较对照组显著升高(t=-19.585，P < 0.01)，OAB组膀胱空虚期Cho含量较对照组升高(t=-2.243，P=0.033)；2组分别行组内比较，OAB组膀胱充盈期Cho含量显著高于膀胱空虚期(t=-17.989，P < 0.01)，对照组膀胱充盈期与膀胱空虚期Cho含量差异无统计学意义(t=-1.254，P=0.220)。2组年龄(P=0.577)、BMI(P=0.698)等指标比较差异无统计学意义。结论 1H-MRS分析技术在女性OAB的诊断中可能具有较好的潜在价值。Abstract: Objective To explore the difference in bladder wall choline levels between female patients with overactive bladder(OAB) and healthy controls using hydrogen proton magnetic resonance spectroscopy(1H-MRS) technology and explore the potential diagnostic value.Methods Female patients diagnosed with overactive bladder(OAB group) at Hefei Second People's Hospital from July 2022 to August 2023 and female healthy volunteers(control group) who matched the age and BMI of the patients during the same period were selected. All subjects underwent two multi-voxel 1H-MRS scans of the bladder, one when the initial urge to urinate(bladder filling period) and after emptying the bladder(empty bladder period). The Siemens Skyra 3.0T magnetic resonance imaging system's built-in post-processing software was used to calculate the choline(Cho)/creatine(Cr) ratios of the anterior, posterior and bilateral bladder walls, and the t test was used to conduct inter-group analysis. and intra-group comparison.Results In this study, 23 cases were included in the OAB group and 17 cases were included in the control group. Compared with the control group, the choline content of the OAB group during the bladder filling phase was significantly higher than that of the healthy control group(t=-19.585, P < 0.01), and the choline content of the OAB group during the empty bladder phase was significantly higher than that of the healthy control group(t=-2.243, P=0.033); intra-group comparisons were made between the two groups. The choline content in the bladder filling phase of the OAB group was significantly higher than that during the bladder emptying phase(t=-17.989, P < 0.01). The choline content in the bladder of the healthy control group showed no significant difference(t=-1.254, P=0.220). There was no statistically significant difference in age(P=0.577), body mass score(BMI)(P=0.698) or other indicators between the two groups.Conclusion 1H-MRS analysis may have good potential value in the diagnosis of female overactive bladder.
-
-
表 1 OAB组及对照组患者充盈期与空虚期膀胱1H-MRS数据结果组间和组内比较
X±S 组别 膀胱充盈期Cho/Cr值 膀胱空虚期Cho/Cr值 t P值 OAB组(23例) 1.765 6±0.191 7 1.004 7±0.066 2 -17.989 < 0.01 对照组(17例) 0.979 4±0.013 9 0.971 8±0.019 1 -1.254 0.220 t -19.585 -2.243 P值 < 0.01 0.033 
下载: 导出CSV
-
[1] Corcos J, Przydacz M, Campeau L, et al. CUA guideline on adult overactive bladder[J]. J De L'association Des Urol Du Can, 2017, 11(5): E142-E173.
[2] Irwin DE, Milsom I, Hunskaar S, et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study[J]. Eur Urol, 2006, 50(6): 1306-1314;discussion 1314-1315.
[3] Tran KH, Luki J, Hanstock S, et al. Decreased GABA+ levels in the medial prefrontal cortex of perimenopausal women: a 3T 1H-MRS study[J]. Int J Neuropsychopharmacol, 2023, 26(1): 32-41. doi: 10.1093/ijnp/pyac066
[4] Laakso MP, Jukarainen NM, Vepsäläinen J. Diagnosis of dementias by high-field 1H MRS of cerebrospinal fluid[J]. J Neurol Neurosurg Psychiatry, 2015, 86(12): 1286-1290.
[5] Lu J, Li Y, Li YA, et al. In vivo detection of dysregulated choline metabolism in paclitaxel-resistant ovarian cancers with proton magnetic resonance spectroscopy[J]. J Transl Med, 2022, 20(1): 92. doi: 10.1186/s12967-022-03292-z
[6] 宋静, 宗会迁, 张娅, 等. 磁共振波谱联合减影技术在高级别胶质瘤影像组学分级预测的研究[J]. 磁共振成像, 2023, 14(6): 59-65.
[7] 李欣, 谢继承, 王静, 等. 磁共振MRS、DWI及SWI序列在脑胶质瘤分级诊断中的应用价值[J]. 中华全科医学, 2022, 20(9): 1541-1544.
[8] Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society[J]. Am J Obstet Gynecol, 2002, 187(1): 116-126. doi: 10.1067/mob.2002.125704
[9] Lantos PM, Rumbaugh J, Bockenstedt LK, et al. Clinical practice guidelines by the infectious diseases society of America(IDSA), American academy of neurology(AAN), and American college of rheumatology(ACR): 2020 guidelines for the prevention, diagnosis and treatment of Lyme disease[J]. Clin Infect Dis, 2021, 72(1): 1-8. doi: 10.1093/cid/ciaa1215
[10] Drake MJ, Mills IW, Gillespie JI. Model of peripheral autonomous modules and a myovesical plexus in normal and overactive bladder function[J]. Lancet, 2001, 358(9279): 401-403. doi: 10.1016/S0140-6736(01)05549-0
[11] Brading AF. Spontaneous activity of lower urinary tract smooth muscles: correlation between ion channels and tissue function[J]. J Physiol, 2006, 570(Pt 1): 13-22.
[12] Andersson KE. Detrusor myocyte activity and afferent signaling[J]. Neurourol Urodyn, 2010, 29(1): 97-106. doi: 10.1002/nau.20784
[13] Cerruto MA, Asimakopoulos AD, Artibani W, et al. Insight into new potential targets for the treatment of overactive bladder and detrusor overactivity[J]. Urol Int, 2012, 89(1): 1-8. doi: 10.1159/000339251
[14] Brading AF. Acetylcholine and the overactive bladder[J]. Eur Urol, 2007, 51(4): 881-883. doi: 10.1016/j.eururo.2006.10.029
[15] Andersson KE. Antimuscarinic mechanisms and the overactive detrusor: an update[J]. Eur Urol, 2011, 59(3): 377-386.
[16] Jing M, Li YX, Zeng JZ, et al. An optimized acetylcholine sensor for monitoring in vivo cholinergic activity[J]. Nat Methods, 2020, 17(11): 1139-1146.
[17] Mukherjee J, Kirchhoff JR. Electrocatalytic microelectrode detectors for choline and acetylcholine following separation by capillary electrophoresis[J]. Anal Chem, 2009, 81(16): 6996-7002.
[18] Sheyn D, Hijaz AK, Hazlett FE Jr, et al. Evaluation of Choline and Acetylcholine Levels in Responders and Nonre sponders to Anticholinergic Therapy for Overactive Bladder Syndrome[J]. Female Pelvic Med Reconstr Surg, 2020, 26(12): e91-e6.
[19] Friesen AJD, Ling GM, Nagai M. Choline and phospholipid-choline in a sympathetic ganglion and their relationship to acetylcholine synthesis[J]. Nature, 1967, 214: 722-724.
[20] 王建枝. 通过质子磁共振波谱分析间接检测乙酰胆碱含量的方法CN101290297A[P]. 2008-10-22.
[21] Chapple CR, Khullar V, Gabriel Z, et al. The effects of antimuscarinic treatments in overactive bladder: an update of a systematic review and meta-analysis[J]. Eur Urol, 2008, 54(3): 543-562.
[22] Lo CW, Wu MY, Yang SS, et al. Comparing the efficacy of OnabotulinumtoxinA, sacral neuromodulation, and peripheral tibial nerve stimulation as third line treatment for the management of overactive bladder symptoms in adults: systematic review and network meta-analysis[J]. Toxins, 2020, 12(2): 128.
-
图(1)
表(1)
计量
- 文章访问数: 1060
- PDF下载数: 278
- 施引文献: 0