利用 PACS 集成的超声引导乳腺活检模拟练习来强化放射科住院医师培训期间超声引导经皮乳腺介入程序的 ACR 实践指南。

Utilizing a PACS-integrated ultrasound-guided breast biopsy simulation exercise to reinforce the ACR practice guideline for ultrasound-guided percutaneous breast interventional procedures during radiology residency.

机构信息

Department of Radiology, Breast Imaging Section, Stanford University School of Medicine, CA 94305, USA.

出版信息

Acad Radiol. 2011 Oct;18(10):1324-8. doi: 10.1016/j.acra.2011.06.003.

DOI:10.1016/j.acra.2011.06.003

PMID:21893299

Abstract

RATIONALE AND OBJECTIVES

A picture archiving and communication system (PACS)-integrated ultrasound-guided (USG) breast intervention simulation exercise was designed for radiology residency education. The purpose of this study was to describe the initial experience and determine if resident understanding of the American College of Radiology (ACR) practice guideline for the performance of USG percutaneous breast interventional procedures and procedural confidence is improved with the implementation of this simulation exercise.

MATERIALS AND METHODS

Radiology residents (n = 11) volunteered to perform percutaneous USG cyst aspiration, 14-gauge automated core biopsy, and 10-gauge vacuum core biopsy on turkey breast phantoms, with an emphasis on capturing ultrasound images demonstrating appropriate documentation of the procedure and image annotation according to the ACR practice guideline for USG percutaneous interventions. The images were transmitted to the PACS for subsequent attending radiologist review. Survey responses regarding procedural confidence and knowledge of the ACR practice guideline were compared between residents with and without the simulator experience.

RESULTS

Residents with simulation exercise experience showed statistically significant increases in confidence performing USG core biopsies, operating biopsy devices and ultrasound equipment, and knowledge of appropriate needle positioning and image annotation and documentation according to the ACR practice guideline. The increased confidence seen in performing USG cyst aspiration barely missed statistical significance (P = .056), likely because of residents' baseline familiarity with the procedure.

CONCLUSIONS

A PACS-integrated USG breast intervention simulation exercise increases residents' procedural confidence and understanding of the ACR practice guideline for the performance of USG percutaneous breast interventional procedures.

摘要

背景与目的

本研究设计了一种与影像归档与通讯系统（PACS）集成的超声引导（USG）乳腺介入模拟训练，用于放射科住院医师教育。本研究的目的在于描述初步经验，并确定在实施该模拟训练后，住院医师对美国放射学院（ACR）关于 USG 经皮乳腺介入性操作实践指南的理解以及操作信心是否得到改善。

材料与方法

放射科住院医师（n = 11）自愿对火鸡乳房模型进行经皮 USG 囊液抽吸、14 号自动活检枪和 10 号真空活检枪操作，重点是采集能够根据 ACR 关于 USG 经皮介入操作的实践指南，适当记录手术过程和图像注释的超声图像。这些图像被传输到 PACS 中，以便随后由主治放射科医师进行审查。对具有和不具有模拟器经验的住院医师进行了关于操作信心和对 ACR 实践指南的了解的调查回复比较。