Application of color ultrasound-guided bladder biopsy in the diagnosis of pediatric eosinophilic cystitis

Abstract

Objective To explore the application of ultrasound-guided bladder biopsy in the diagnosis of pediatric eosinophilic cystitis (EC). Methods The clinical data were retrospectively reviewed for 7 children diagnosed as EC by bladder biopsy under a guidance of color Doppler ultrasound from January 2014 to October 2017.The diagnostic value was analyzed with the relevant literatures.There were 5 boys and 2 girls with an average age of 8.1 years and the course of disease for 3-20 days.The major clinical manifestations were irritative bladder symptoms and lower abdominal pain.Among them, 5 children had additional ultrasound-guided bladder biopsy under local (n=1) and general (n=4) anesthesia when the diagnosis was unclear by initial cystoscopic biopsy under general anesthesia.Two children underwent ultrasound-guided bladder biopsy under local (n=1) and general (n=1) anesthesia.The diagnostic results of five children undergoing cystoscopic biopsy and additional ultrasound-guided bladder biopsy were matched and compared.SPSS 24.0 software was used for conducting hypothesis test and comparative analysis with α=0.1 as a standard. Results All children undergoing ultrasound-guided bladder biopsy had satisfactory biopsy results and no significant complications occurred.Initial biopsy in 5 cases of cystoscopic biopsy failed to confirm the diagnosis and then ultrasound-guided biopsy established the diagnosis of EC.Two children undergoing ultrasound-guided biopsy were directly diagnosed as EC during the first biopsy.As shown by the result of hypothesis test, if suspected diagnoses were not treated as misdiagnoses, there was not statistically significant difference in misdiagnostic rate of EC (χ2=1.33 0.1). However, if suspected diagnoses were treated as undetermined diagnoses, then no statistically significant difference existed in accuracy rate (χ2=3.2>2.7, P<0.1). Conclusions Bladder biopsy guided by color Doppler ultrasound has the advantages of high accuracy rate, safety and easy handling.Furthermore, local anesthesia is sufficient for elder children so that cystoscopy and risk of general anesthesia are avoided.So it is a preferred method of diagnosing pediatric EC. Key words: Cystitis; Biopsy, needle; Eosinophil; Diagnosis