Echocardiography Laboratory, Centro Cardiologico Monzino, IRCCS, Milano, Italy.
J Telemed Telecare. 2012 Jun;18(4):204-10. doi: 10.1258/jtt.2012.111011. Epub 2012 May 17.
We assessed the feasibility, image adequacy and clinical utility of a tele-echocardiography service which combined video compression with low-bandwidth store-and-forward transmission. Echocardiograms were acquired by a hospital geriatrician, compressed and transmitted using both near real-time (urgent) and delayed (pre-programmed) protocols via an Internet connection to the notebook PC of a remote cardiologist. Clinical utility was evaluated as a change in therapeutic management. During a one-year period, 101 tele-echocardiography consultations were successfully performed (feasibility = 100%) on 95 patients (age 22-95 years), admitted with cardiovascular or neurological diagnoses (24% of the consultations were urgent). In total, 4617 files (1.4 GByte of data) were transmitted, 2669 of which were short video clips. On average, 46 files (13.8 MByte) were transmitted (mean duration 10 min) at each examination. Consultations (both urgent and pre-programmed) were clinically useful in 83% of examinations. Logistic regression analysis showed that both a low left ventricular systolic function and the examination indication were determinants of clinical utility. The transmitted images were considered adequate for diagnosis in 100% of the pre-programmed teleconsultations. Tele-echocardiography using MPEG-4 video compression is a feasible, adequate and clinically useful tool for telemedicine.
我们评估了一种远程超声心动图服务的可行性、图像质量和临床应用价值，该服务结合了视频压缩和低带宽存储转发传输。由医院老年病学家获取超声心动图，使用近实时（紧急）和延迟（预编程）协议通过互联网连接到远程心脏病专家的笔记本电脑进行压缩和传输。临床应用价值评估为治疗管理的变化。在一年的时间里，成功地对 95 名患者（年龄 22-95 岁）进行了 101 次远程超声心动图咨询（可行性=100%），这些患者患有心血管或神经系统疾病（24%的咨询是紧急的）。总共传输了 4617 个文件（1.4GB 数据），其中 2669 个是短视频剪辑。在每次检查中，平均传输 46 个文件（13.8MB）（平均持续时间 10 分钟）。在 83%的检查中，咨询（包括紧急和预编程）具有临床意义。逻辑回归分析表明，左心室收缩功能低和检查指征都是临床应用价值的决定因素。在 100%的预编程远程咨询中，传输的图像被认为足以用于诊断。使用 MPEG-4 视频压缩的远程超声心动图是远程医疗的一种可行、充分和具有临床意义的工具。
