发表机构
Cleveland Clinic Lerner Research Institute; Glickman Urological and Kidney Institute; Case Western Reserve University; Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University; Louis Stokes Cleveland Veterans Affairs Medical Center; SRS Medical（克利夫兰诊所勒纳研究所; 格里克曼泌尿与肾脏研究所; 凯斯西储大学; 凯斯西储大学电气、计算机与系统工程系; 路易斯·斯托克斯克利夫兰退伍军人事务医疗中心; SRS医疗公司）
机构由 AI 辅助整理，请以论文原文为准。AI 中文总结
本研究提出用单个膀胱压通道联合腹部肌电估计逼尿肌压力，无需腹部导管，经40例验证，评分中位数93%，可提升UDS舒适度与准确性。
AI 中文摘要
目的：本研究旨在通过开发一种新颖的框架，仅使用单个膀胱压（Pves）通道结合表面腹部肌电（AEMG）电极阵列来估计逼尿肌压力（Pdet），从而无需腹部导管，提升尿动力学检查（UDS）中的患者舒适度和诊断准确性。所提出的方法设计为实时运行，并与当前UDS临床硬件兼容。方法：共进行了40次UDS研究，同时测量AEMG以及Pves和Pabd。每次研究前使用预定的、激发性的腹部操作，以确保AEMG信号与Pves中相关的腹部压力之间准确耦合。设定了标准以判断耦合是否足以从Pves和AEMG估计Pdet。事后信号处理用于进一步细化和评估估计的Pdet，采用自动化的非因果事件检测。使用基于事件的评分指标，通过计算该事件中适当通道（Pdet与腹部压力）所含信号的百分比，来确定该方法估计Pdet的准确性。结果：结果显示，40例中有30例在激发性操作后指示“Go”状态，表明该方法在大多数UDS研究中具有可行性。评分指标连同相关性分析确认了估计Pdet的准确性，评分范围为85%至95%，中位数为93%。意义：这种创新方法有潜力通过提供更舒适、更准确的膀胱功能评估诊断工具，彻底改变尿动力学研究。这对老年人和儿童等弱势群体尤其有益，减少了对多根导管的需求，并改善了UDS期间的整体患者体验。
英文摘要
Objective: The aim of this study was to enhance patient comfort and diagnostic accuracy in urodynamic studies (UDS) by developing a novel framework that uses a single vesical pressure (Pves) channel combined with a surface abdominal electromyography (AEMG) electrode array to estimate detrusor pressure (Pdet) without the need for an abdominal catheter. The proposed method was designed to operate in real-time, and to be compatible with current UDS clinical hardware. Methods: 40 UDS studies were performed with AEMG measured simultaneously with both Pves and Pabd. A predefined, provocative abdominal maneuver was used before each study to ensure accurate coupling between the AEMG signal and associated abdominal pressures seen in Pves. Criteria were set to determine if coupling was sufficient for Pdet estimation from Pves and AEMG. Post-hoc signal processing was used to further refine and evaluate estimated Pdet using automated, non-causal event detection. An event-based scoring metric was used to determine how accurately this approach estimated Pdet by calculating the percentage of signal contained in the appropriate channel for that event (Pdet vs abdominal pressure). Results: The results showed that 30 of the 40 cases indicated a "Go" status after the provocative maneuver, demonstrating feasibility of this method in a majority of UDS studies. The scoring metric, along with correlation analysis, confirmed accuracy of estimated Pdet with scores ranging from 85% to 95% with median at 93%. Significance: This innovative approach has the potential to revolutionize urodynamic studies by providing a more comfortable and accurate diagnostic tool for assessing bladder function. This is particularly beneficial for vulnerable populations, such as the elderly and children, reducing the need for multiple catheters and improving the overall patient experience during UDS.
