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Quantitative assessment of bladder wall vascularity index in children with acute cystitis using superb microvascular imaging



The purpose of this study was to investigate the effectiveness of the vascularization index (VI) obtained using color superb microvascular imaging (cSMI) technique in assessment of the anterior urinary bladder wall in pediatric patients with acute cystitis (AC).


The anterior bladder wall of 157 patients (age range 13–84 months, mean 43.62 ± 17.79 months) whose clinical and laboratory findings were proven of AC and 150 healthy asymptomatic participants (age range 13–84 months, mean 43.88 ± 18.11 months) with normal laboratory values were examined using cSMI. VI measurements were performed by manually drawing the contours of the anterior bladder wall using the free region of interest with 2-dimensional cSMI VI (2DcSMIVI) mode. The quantitative 2DcSMIVI values of the symptomatic group and the asymptomatic group were compared. The correlation between the 2DcSMIVI values and the anterior bladder wall thickness (BWT) were analyzed.


The mean 2DcSMIVI values of the BWT were significantly higher in symptomatic group when compared to the asymptomatic group (p<0.001). AC can be diagnosed with a 93% sensitivity, 92% specificity when 3.25% 2DcSMIVI designated as the cutoff value. There was a significant positive correlation between 2DcSMIVI values and BWT (p<0.001).


Two-dimensional cSMI VI can be used effectively in children as an imaging method in the diagnosis of AC.

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We would like to thank Funda Gökgöz Durmaz for providing help in the statistical analysis of the study.

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Correspondence to Fatih Ates.

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The authors declare that there are no financial or other relations that could lead to a conflict of interest.

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This study was approved by the local research ethics committee with the number of 70632468-050.01.04/ in SelcukUniversity/Konya—Turkey and all the parents of children were informed about the examinations and the procedure, and their written consents were obtained before the US examination.

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Ates, F., Durmaz, M.S., Yorulmaz, A. et al. Quantitative assessment of bladder wall vascularity index in children with acute cystitis using superb microvascular imaging. J Ultrasound 25, 27–33 (2022).

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