Kjesbu Ingunn E, Laursen Christian B, Graven Torbjørn, Holden Hans Martin, Rømo Bjørnar, Newton Andersen Garrett, Mjølstad Ole Christian, Lassen Annmarie, Dalen Håvard
University of Southern Denmark, Odense, Denmark.
Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway.
J Ultrasound Med. 2017 Jun;36(6):1195-1202. doi: 10.7863/ultra.16.05077. Epub 2017 Feb 28.
We aimed to study the feasibility and diagnostic performance of bedside ultrasound by examination of the liver, gallbladder, kidneys, and abdominal aorta performed by medical residents with limited experience in ultrasound, on emergency admissions using pocket-sized imaging devices (PSIDs).
A total of 199 patients admitted acutely to the medical department at the non-university Levanger Hospital, Norway, during the period from April 4 to June 23, 2011, were consecutively included. Six medical residents, selected by drawing, examined these patients with a PSID at admission. Reference imaging was performed and/or judged at the Department of Radiology.
Each resident performed a median of 28 examinations (interquartile range 24-46). Imaging of the kidneys and liver were feasible in 85 and 82% of the cases, and the corresponding values for the gallbladder and abdominal aorta were 79 and 50%, respectively. The sensitivity of medical residents to detect organ pathology with the aid of PSID, ranged between 54% (95% confidence interval [CI]: 29-77%) and 74% (95% CI: 51-88%). Assessment of the aortic dimension showed moderate correlation, with r = 0.38.
Examination by PSID by inexperienced residents may allow for early detection of abdominal pathology, but do not appear to be accurate enough to rule out pathology in the abdominal organs.
我们旨在研究在急诊入院时，由超声经验有限的住院医师使用袖珍成像设备（PSID）对肝脏、胆囊、肾脏和腹主动脉进行检查的床边超声检查的可行性和诊断性能。
连续纳入2011年4月4日至6月23日期间在挪威非大学附属医院勒旺厄尔医院内科急性入院的199例患者。通过抽签选出的6名住院医师在患者入院时使用PSID对这些患者进行检查。在放射科进行参考成像和/或判断。
每位住院医师的检查中位数为28次（四分位间距为24 - 46次）。肾脏和肝脏成像在85%和82%的病例中可行，胆囊和腹主动脉的相应值分别为79%和50%。住院医师借助PSID检测器官病变的敏感性在54%（95%置信区间[CI]：29 - 77%）至74%（95% CI：51 - 88%）之间。主动脉尺寸评估显示中度相关性，r = 0.38。
经验不足的住院医师使用PSID进行检查可能有助于早期发现腹部病变，但似乎不够准确，无法排除腹部器官的病变。
