Tootian Tourghabe Javad, Arabikhan Hamid Reza, Alamdaran Ali, Zamani Moghadam Hamid
Emergency Department, Hasheminejad Hospital, Mashhad University Of Medical Sciences, Mashhad, Iran.
Emergency Department, Imam Reza Hospital, Mashhad University Of Medical Sciences, Mashhad, Iran.
Emerg (Tehran). 2018;6(1):e19. Epub 2018 Mar 15.
Dependence of ultrasonography on the operator's skill plays a major role in the differences between various studies in reporting its diagnostic accuracy. Therefore, the present study was done with the aim of comparing the ultrasonography findings performed by emergency medicine resident and radiologist in evaluation of acute cholecystitis.
The present diagnostic accuracy study has been carried out on patients presenting to the emergency department with complaint of pain in the right upper quadrant of abdomen suspected with acute cholecystitis. All the patients underwent gallbladder ultrasonography by a trained emergency medicine resident and a radiologist and their findings were compared with surgical and pathology findings regarding gallstone and increased gallbladder wall thickness.
51 patients with the mean age of 42.3±15.8 (17-81) years were analyzed (82.4% female). The overall agreement between emergency medicine resident and radiologist in ultrasonographic diagnosis of cholecystitis was 0.421 (95% CI: 0.118-0.724). Based on the pathology and surgical findings, acute cholecystitis was confirmed for all 51 (100%) patients. Meanwhile, based on the ultrasonographic report of radiologist and emergency medicine resident only 45 (88.2%) and 34 (66.7%) patients, respectively, were diagnosed with cholecystitis. Screening performance characteristics of ultrasonography by radiologist for detection of gallbladder stone (p = 0.010) and gallbladder wall thickness (p < 0.0001) were significantly better than emergency medicine resident.
The screening performance characteristics of ultrasonography by radiologist in detection of gallstones and increased wall thickness of gallbladder were significantly better.
超声检查对操作者技能的依赖性在不同研究报告其诊断准确性的差异中起主要作用。因此，本研究旨在比较急诊医学住院医师和放射科医生在评估急性胆囊炎时的超声检查结果。
本诊断准确性研究针对因右上腹疼痛就诊于急诊科且疑似急性胆囊炎的患者进行。所有患者均由一名经过培训的急诊医学住院医师和一名放射科医生进行胆囊超声检查，并将他们的检查结果与关于胆结石和胆囊壁增厚的手术及病理结果进行比较。
分析了51例平均年龄为42.3±15.8（17 - 81）岁的患者（82.4%为女性）。急诊医学住院医师和放射科医生在超声诊断胆囊炎方面的总体一致性为0.421（95%可信区间：0.118 - 0.724）。根据病理和手术结果，所有51例（100%）患者均确诊为急性胆囊炎。同时，根据放射科医生和急诊医学住院医师的超声报告，分别仅有45例（88.2%）和34例（66.7%）患者被诊断为胆囊炎。放射科医生超声检查检测胆结石（p = 0.010）和胆囊壁增厚（p < 0.0001）的筛查性能特征明显优于急诊医学住院医师。
放射科医生超声检查在检测胆结石和胆囊壁增厚方面的筛查性能特征明显更好。
