Parashar Satish K, Jain Vidyut
Department of Cardiology, Metro Hospitals & Heart Institute, New Delhi, India.
Indian Heart J. 2011 Mar-Apr;63(2):185-9.
To assess the diagnostic potential of the latest and smallest pocket carried ultrasound (PCU) in both normal and diseased hearts, to compare its imaging quality and information provided with a high end standard equipment (HSE), and how quickly a clinically meaningful information could be obtained.
61 consecutive unselected patients, during the five days referral, formed the study material. 41 patients were outpatient referrals and 20 were bed side studies in either emergency room or intensive care units. Their mean age was 47 years. Every patient underwent two echocardiographic studies, first by the PCU and then followed by a detailed study with HSE. Standard echo planes were scanned and both 2- dimensional and color flow mapping studies were performed.
An interpretable scan by Hand carried ultrasound (HCU) was obtained in 57/61 patients. In only 3 cases mild LVH and mild cardiomegaly was missed by HCU, mainly because linear dimensions were not taken with HCU. In all other cases there was agreement between the two examinations which included cases with regional wall motion abnormalities (RWMA), pericarditis, valvular lesions etc. Evaluation of LV ejection fraction, whether normal or deranged, was correctly evaluated in 55/61 patients by both echo techniques. All 3 cases of cardiac murmur were correctly evaluated by HCU which included one case of mitral and tricuspid stenosis. HCU studies changed the management strategies of 2 cases, 1 showing RWMA which necessitated immediate intervention and 1 case of COPD which was diagnosed as dilated cardiomyopathy. The imaging quality of HCU as obtained on LCD screen was well comparable with HSE. The same applied to color flow mapping. The main advantage of HCU was a quick response time in emergency cases due to its easy portability. Moreover the time taken to get meaningful diagnostic information was 5 mins. and 30 secs.
The pocket held scanner is a substantial development in clinical decision making in a tertiary cardiac centre. It provides a rapid and accurate method in identifying patients both with normal and diseased hearts, thereby influencing their disposal both in OPD and emergency areas.
评估最新、最小的便携式超声（PCU）对正常及患病心脏的诊断潜力，比较其与高端标准设备（HSE）的成像质量及所提供的信息，以及获取具有临床意义信息的速度。
在五天的转诊期间，连续选取61例未经挑选的患者作为研究对象。其中41例为门诊转诊患者，20例为急诊室或重症监护病房的床边检查患者。他们的平均年龄为47岁。每位患者均接受两项超声心动图检查，首先使用PCU进行检查，然后再使用HSE进行详细检查。扫描标准的超声心动图平面，并进行二维和彩色血流图检查。
61例患者中有57例获得了可解读的手持式超声（HCU）扫描结果。仅有3例患者的轻度左心室肥厚和轻度心脏扩大被HCU漏诊，主要原因是HCU未测量线性尺寸。在所有其他病例中，包括局部室壁运动异常（RWMA）、心包炎、瓣膜病变等病例，两种检查结果一致。两种超声技术对55/61例患者的左心室射血分数（无论正常或异常）评估均正确。所有3例心脏杂音病例均被HCU正确评估，其中包括1例二尖瓣和三尖瓣狭窄病例。HCU检查改变了2例患者的治疗策略，1例显示RWMA需要立即干预，1例慢性阻塞性肺疾病（COPD）患者被诊断为扩张型心肌病。在液晶显示屏上获得的HCU成像质量与HSE相当。彩色血流图检查也是如此。HCU的主要优势在于因其易于携带，在紧急情况下响应时间短。此外，获取有意义诊断信息所需的时间为5分30秒。
便携式扫描仪是三级心脏中心临床决策的重大进展。它为识别正常及患病心脏的患者提供了一种快速且准确的方法，从而影响门诊和急诊区域对患者的处理。
