A Feasibility Study to Determine Whether Clinical Contrast Enhanced Magnetic Resonance Imaging can Detect Increased Bladder Permeability in Patients with Interstitial Cystitis.

Autor:	Towner RA; Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma; Stephenson Cancer Center, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma. Electronic address: Rheal-Towner@omrf.org., Wisniewski AB; Department of Urology, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma., Wu DH; Department of Radiological Sciences, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma., Van Gordon SB; Department of Urology, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma., Smith N; Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma., North JC; Department of Radiological Sciences, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma., McElhaney R; Stephenson Cancer Center, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma., Aston CE; Department of Pediatrics, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma., Shobeiri SA; Department of Obstetrics and Gynecology, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma., Kropp BP; Department of Urology, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma., Greenwood-Van Meerveld B; Department of Physiology, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma., Hurst RE; Department of Urology, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma; Department of Biochemistry and Molecular Biology, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma; Stephenson Cancer Center, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma.
Jazyk:	angličtina
Zdroj:	The Journal of urology [J Urol] 2016 Mar; Vol. 195 (3), pp. 631-8. Date of Electronic Publication: 2015 Aug 22.
DOI:	10.1016/j.juro.2015.08.077
Abstrakt:	Purpose: Interstitial cystitis/bladder pain syndrome is a bladder pain disorder associated with voiding symptomatology and other systemic chronic pain disorders. Currently diagnosing interstitial cystitis/bladder pain syndrome is complicated as patients present with a wide range of symptoms, physical examination findings and clinical test responses. One hypothesis is that interstitial cystitis symptoms arise from increased bladder permeability to urine solutes. This study establishes the feasibility of using contrast enhanced magnetic resonance imaging to quantify bladder permeability in patients with interstitial cystitis. Materials and Methods: Permeability alterations in bladder urothelium were assessed by intravesical administration of the magnetic resonance imaging contrast agent Gd-DTPA (Gd-diethylenetriaminepentaacetic acid) in a small cohort of patients. Magnetic resonance imaging signal intensity in patient and control bladders was compared regionally and for entire bladders. Results: Quantitative assessment of magnetic resonance imaging signal intensity indicated a significant increase in signal intensity in anterior bladder regions compared to posterior regions in patients with interstitial cystitis (p <0.01) and significant increases in signal intensity in anterior bladder regions (p <0.001). Kurtosis (shape of probability distribution) and skewness (measure of probability distribution asymmetry) were associated with contrast enhancement in total bladders in patients with interstitial cystitis vs controls (p <0.05). Regarding symptomatology interstitial cystitis cases differed significantly from controls on the SF-36®, PUF (Pelvic Pain and Urgency/Frequency) and ICPI (Interstitial Cystitis Problem Index) questionnaires with no overlap in the score range in each group. ICSI (Interstitial Cystitis Symptom Index) differed significantly but with a slight overlap in the range of scores. Conclusions: Data suggest that contrast enhanced magnetic resonance imaging provides an objective, quantifiable measurement of bladder permeability that could be used to stratify bladder pain patients and monitor therapy. (Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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