Multi-modal ultrasound for evaluating structure and function of neurogenic bladder in pediatrics

This study aimed to investigate the possibility of Multi-modal ultrasound (MMU) replacing urodynamic study (UDS) in the evaluation of neurogenic bladder (NB) in Pediatrics. MMU examinations were conducted on 73 NB patients (NB group) and 100 healthy group (HG). MMU parameters of vesical volume (VV), bladder wall thickness (BWT), shear wave velocity (SWV), resistance index (RI), vascularization index (VI), and ultrasound bladder compliance (△C) were collected. Then, the above parameters were compared between the groups and a diagnosis model was constructed. The correlation of MMU parameters with bladder compliance (BC) and detrusor leak point pressure (DLPP) was analyzed. NB group showed increased emptying VV, mean BWT, filling SWV, emptying SWV, and VI, with a decrease in △C compared to the HG. Parameters of filling SWV, △C, emptying SWV, mean BWT, and VI all demonstrated high diagnostic values, particularly filling SWV, which showed the highest value. An equation was formulated using the three MMU parameters with the highest AUC values: Logit (P: NB) = -12.816-0.040 × △C + 3.518 × filling SWV + 2.009 × VI. No significant difference was observed between the diagnostic model and UDS in the diagnosis of NB. In the NB group, BC and DLPP were correlated with most MMU parameters. The constructed diagnostic model based on filling SWV, △C, and VI shows a high possibility of replacing UDS in Pediatrics to evaluate NB.