Lavi Arnon, Tzemah Sharon, Hussein Anan, Bishara Ibrahim, Shcherbakov Nikolay, Zelichenko Genady, Mashiah Alon, Gross Michael, Cherbinski Leonid, Neeman Ziv, Cohen Michael
Department of Urology, Haamek Medical Center, Afula, Israel.
Department of Radiology, Haamek Medical Center, Afula, Israel.
Int Urol Nephrol. 2017 Sep;49(9):1513-1518. doi: 10.1007/s11255-017-1641-8. Epub 2017 Jun 22.
Ultrasound is commonly used in urology. Technical advances with reduced size and cost led to diffusion of small ultrasound devices to many clinical settings. Even so, most ultrasound studies are performed by non-urologists. We aimed to evaluate the utility of a pocket-size ultrasound device (Vscan™ GE Healthcare) and the quality of urologist performed study.
Three consecutive studies were performed: (1) a urologist using the pocket ultrasound, (2) a sonographist using the pocket ultrasound, and (3) a sonographist using a standard ultrasound device. Thirty-six patients were evaluated with a basic urologic ultrasound study. An excepted deviation between studies was preset for numeric parameters and t test performed. Ordinal parameters were analyzed using Cohen's kappa coefficient.
Kidney length, renal pelvis length, renal cyst diameter, post-void residual and prostate volume (transabdominal) differences were found to be insignificant when comparing a urologist pocket ultrasound study to a sonographist standard ultrasound study (P = 0.15; P = 0.21; P = 0.81; P = 0.32; P = 0.07, respectively). Hydronpehrosis evaluation (none, mild, moderate and severe) and the presence of ureteral jet signs conferred a high inter-observer agreement when comparing the above studies using the Cohen's kappa coefficient (K = 0.63; K = 0.62, respectively).
Urologist performed pocket ultrasound study is valid in evaluating the upper and lower urinary tract and is practical in many clinical scenarios. The urologic stethoscope is now becoming a reality within reach.
超声在泌尿外科中常用。尺寸减小和成本降低的技术进步导致小型超声设备在许多临床环境中得到普及。即便如此,大多数超声检查是由非泌尿外科医生进行的。我们旨在评估一种袖珍型超声设备(Vscan™通用电气医疗集团)的效用以及泌尿外科医生进行的检查质量。
进行了三项连续研究:(1)一名泌尿外科医生使用袖珍超声,(2)一名超声科医生使用袖珍超声,(3)一名超声科医生使用标准超声设备。对36例患者进行了基本的泌尿外科超声检查。针对数值参数预设了研究间的预期偏差并进行t检验。使用科恩kappa系数分析有序参数。
将泌尿外科医生的袖珍超声检查与超声科医生的标准超声检查进行比较时,发现肾长度、肾盂长度、肾囊肿直径、排尿后残余尿量和前列腺体积(经腹)差异无统计学意义(P分别为0.15;0.21;0.81;0.32;0.07)。使用科恩kappa系数比较上述研究时,肾盂积水评估(无、轻度、中度和重度)以及输尿管喷射征的存在显示出较高的观察者间一致性(K分别为0.63;0.62)。
泌尿外科医生进行的袖珍超声检查在评估上尿路和下尿路方面是有效的,并且在许多临床场景中是实用的。泌尿外科听诊器如今正成为触手可及的现实。