Gaarder Mario, Seierstad Therese, Søreng Robin, Drolsum Anders, Begum Kubra, Dormagen Johann Baptist
Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
Acta Radiol. 2015 Mar;56(3):368-73. doi: 10.1177/0284185114527868. Epub 2014 Mar 10.
The radiographers' role in ultrasound (US) has been debated due to the operator-dependent aspect of diagnostic US. With standardized cine-loop ultrasound (SCUS) a reliable diagnosis can be achieved by reading SCUS independently from performing the procedure.
To study the correlation between sonographic findings when SCUS is performed and read by a radiologist and when SCUS is performed by a radiographer and read by a radiologist, and to assess the radiologists' confidence when reading SCUS examinations performed by a radiographer.
Thirty-four patients (64 kidneys) who underwent SCUS of the kidneys were included in this study. All patients underwent two consecutive SCUS examinations, one performed by an experienced radiologist reading his own examination (online), and one performed by a SCUS-trained radiographer, read by an experienced radiologist who was not involved in the examination of the patient (offline). Study reports were made using a structured report form designed for this study. Confidence was measured on a visual analog scale ranging from 0 (no confidence) to 100 (extremely confident). The final diagnosis (the reference standard) was defined as the consensus between two US-experienced radiologists. All personnel were blinded to each other's results.
We found discordance between image findings for online and offline in eight out of 64 kidneys. There was no systematic difference between online and offline reading. There was a good correlation between online and offline, kappa 0.75 (95% CI 0.60-0.90, P < 0.001). Kappa correlation for online and offline compared to reference standard was 0.94 (95% CI 0.86-1.00, P < 0.001) and 0.81 (95% CI 0.66-0.96, P < 0.001), respectively. Radiologists reported a confidence level of 88 (range, 74-94) and 85 (range, 67-92) in the online and offline group, respectively (P = 0.005).
There is a high degree of correlation between reported findings in radiologist and radiographer performed SCUS examinations.
由于诊断性超声检查依赖操作者，放射技师在超声检查中的作用一直存在争议。使用标准化动态循环超声（SCUS），独立于操作过程阅读SCUS即可实现可靠的诊断。
研究放射科医生进行并阅读SCUS检查时与放射技师进行SCUS检查后由放射科医生阅读时超声检查结果之间的相关性，并评估放射科医生阅读放射技师进行的SCUS检查时的信心。
本研究纳入了34例接受肾脏SCUS检查的患者（64个肾脏）。所有患者均连续接受两次SCUS检查，一次由经验丰富的放射科医生进行并阅读自己的检查结果（在线），另一次由经过SCUS培训的放射技师进行，由未参与该患者检查的经验丰富的放射科医生阅读（离线）。研究报告使用为此研究设计的结构化报告表格。信心程度采用视觉模拟量表进行测量，范围从0（无信心）到100（极度自信）。最终诊断（参考标准）定义为两位有超声检查经验的放射科医生的共识。所有人员均对彼此的结果不知情。
我们发现64个肾脏中有8个肾脏的在线和离线图像结果存在不一致。在线和离线阅读之间没有系统性差异。在线和离线之间存在良好的相关性，kappa值为0.75（95%可信区间0.60 - 0.90，P < 0.001）。与参考标准相比，在线和离线的kappa相关性分别为0.94（95%可信区间0.86 - 1.00，P < 0.001）和(0.81（95%可信区间0.66 - 0.96，P < 0.001）。放射科医生报告在线组和离线组的信心水平分别为88（范围74 - 94）和85（范围67 - 92）（P = 0.005）。
放射科医生和放射技师进行的SCUS检查报告结果之间存在高度相关性。
