新しい遠隔操作装置を用いた超音波ドプラ排尿機能検査の有用性に関する検討

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  • 上松 克利
    岡山大学大学院医歯薬学総合研究科　泌尿器病態学

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  • Usefulness of a newly developed tele-operating system for non-invasive ultrasound urodynamics
  • アタラシイ エンカク ソウサ ソウチ オ モチイタ チョウオンパ ドプラ ハイニョウ キノウ ケンサ ノ ユウヨウセイ ニ カンスル ケントウ

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 We previously reported a non-invasive, transperineal, urodynamic technique using Doppler ultrasonography. Recently, we developed a new tele-operating system to control the robotic arm of the ultrasound probe that has a pressure-regulating function and a touch-panel that allows the operator to monitor the exact position of the probe.<br>  From January 2008 to April 2010, 61 cases were examined using this system. Among them, 41 cases were examined by 2 experienced doctors and 20 cases were examined by 5 inexperienced nurses. We then compared the success rate of taking images sufficient for analyzing the velocity parameters and preparation time for setup between these two groups. In 45 out of 61 cases, whose examinations were successfully carried out, the velocity-flow parameters were compared between 19 cases with bladder outlet obstruction (BOO) and 26 without BOO.<br>  Satisfactory images were obtained in 32 cases (78%) by doctors and in 13 cases (65%) by nurses. The preparation time was 9.8 seconds for doctors and 13.2 seconds for nurses, with no statistical difference. The functional cross-sectional area in the prostatic urethra (A1) was significantly smaller in the BOO(+) group (0.056cm2) compared to the BOO(-) group (0.360cm2). The velocity ratio (VR) was significantly higher in the BOO(+) group (1.89) than in the BOO(-) group (0.41).<br>  In conclusion, the newly developed tele-operating system has made it easier for an inexperienced examiner to obtain velocity parameters using Doppler ultrasound urodynamic measurement.

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