Department of Cardiology, Scripps Mercy Hospital, 4060 Fourth Ave #206, San Diego, CA 92103, USA.
Am J Emerg Med. 2012 Jan;30(1):32-6. doi: 10.1016/j.ajem.2010.07.024. Epub 2010 Oct 29.
Although pocket-sized, simplified ultrasound devices have emerged to enable subjective point-of-care assessment, few data on their cardiac application exist. We sought to examine the image quality and the accuracy of subjective diagnosis of video loops obtained from a pocket-sized ultrasound device for 2 significant cardiac abnormalities, left ventricular systolic dysfunction and left atrial enlargement, obtained from a single, quick-look view.
Parasternal left ventricular long-axis images acquired with a miniaturized commercially available device (Acuson P10) were reviewed using subjective criteria for left ventricular systolic dysfunction and left atrial enlargement and were compared with M-mode measurements of left atrial systolic diameter and E-point septal separation from a fully featured echocardiograph in 78 inpatients referred for standard echocardiography. Interpretive confidence and image quality were evaluated with each interpretation.
Of 78 inpatient studies, 19% of pocket ultrasound and 13% of standard studies were technically limited (P = NS). Of 61 technically adequate studies, subjective interpretation of pocket ultrasound images had a sensitivity, specificity, and accuracy of 79%, 52%, and 64% for left atrial diameter more than 4 cm; 47%, 98%, and 82% for E-point septal separation more than 1 cm of; 83%, 62%, and 74% for either abnormality; and 92%, 82%, and 87% for either abnormality when interpretive confidence was present (n = 23). The pocket ultrasound image quality scores were significantly lower than the standard echocardiograph (P < .001).
The pocket-sized device provided adequate imaging for screening of 2 significant cardiac entities. Subjective interpretation of a single parasternal view may help identify patients with cardiac disease.
尽管袖珍简化超声设备已经出现，能够实现即时的床边主观评估，但有关其在心脏方面应用的资料却很少。我们旨在研究从一种袖珍超声设备获得的视频片段的图像质量和对两种重要心脏异常（左心室收缩功能障碍和左心房扩大）的主观诊断的准确性，这些视频片段是通过单次快速观察获得的。
使用主观标准评估来自一种微型商业化设备（Acuson P10）的胸骨旁左心室长轴图像，以评估左心室收缩功能障碍和左心房扩大，并将其与从功能齐全的超声心动图获得的左心房收缩直径的 M 型测量值和 E 点室间隔分离进行比较。在 78 名因标准超声心动图检查而就诊的住院患者中，每次评估时都评估了解释的信心和图像质量。
在 78 项住院患者研究中，有 19%的袖珍超声和 13%的标准研究存在技术限制（P = NS）。在 61 项技术上足够的研究中，对袖珍超声图像的主观解释对左心房直径大于 4cm 的敏感性、特异性和准确性分别为 79%、52%和 64%；E 点室间隔分离大于 1cm 的敏感性、特异性和准确性分别为 47%、98%和 82%；任何异常的敏感性、特异性和准确性分别为 83%、62%和 74%；在解释信心存在的情况下（n = 23），任何异常的敏感性、特异性和准确性分别为 92%、82%和 87%。袖珍超声图像质量评分明显低于标准超声心动图（P <.001）。
该袖珍设备提供了足够的成像，可用于筛查两种重要的心脏实体。对单个胸骨旁视图的主观解释可能有助于识别患有心脏病的患者。
