Xie F, Breese M S, Nanna M, Lichtenberg G S, Allen M N, Meltzer R
Department of Medicine, University of Rochester, NY.
Chest. 1988 Aug;94(2):270-4. doi: 10.1378/chest.94.2.270.
We evaluated blinded readings by a physician using a miniature real-time "ultrasound stethoscope" compared with a "standard" echo instrument used by an independent physician. Size of all four cardiac chambers, wall motion, all four valves, thickness of interventricular septum and left ventricular posterior wall, and pericardial effusion were assessed in 66 patients. Each physician estimated whether he had answered the referring question and gave a final diagnosis. The physician using the ultrasound stethoscope correctly assessed chamber size in 87 percent of cases, segmental left ventricular wall motion in 71 percent of segments studied, and wall thickness in 88 percent of cases, and the diagnosis by the ultrasound stethoscope agreed with that made by the standard instrument in 68 percent of cases. The physician with the ultrasound stethoscope detected structural valvular problems (eg, stenosis) in 70 percent of cases but only detected flow abnormalities (eg, regurgitation) in 14 percent of cases. We conclude that (1) an experienced echocardiographer using an ultrasound stethoscope can detect most structural abnormalities found by a standard echocardiographic instrument; (2) chamber size, valvular stenosis, and pericardial effusions were accurately assessed; (3) the ultrasound stethoscope cannot be used to detect valvular regurgitation; and (4) limitations include the lack of freeze-frame, M-mode, hard copy, and Doppler.
我们评估了一位医生使用微型实时“超声听诊器”进行的盲法读数，并将其与另一位独立医生使用的“标准”超声仪器进行了比较。对66例患者评估了所有四个心腔的大小、壁运动、所有四个瓣膜、室间隔和左心室后壁的厚度以及心包积液情况。每位医生估计自己是否回答了转诊问题并给出最终诊断。使用超声听诊器的医生在87%的病例中正确评估了心腔大小，在71%的研究节段中正确评估了左心室节段壁运动，在88%的病例中正确评估了壁厚度，且超声听诊器做出的诊断在68%的病例中与标准仪器一致。使用超声听诊器的医生在70%的病例中检测到瓣膜结构问题（如狭窄），但仅在14%的病例中检测到血流异常（如反流）。我们得出结论：（1）一位经验丰富的超声心动图医生使用超声听诊器能够检测到标准超声心动图仪器所发现的大多数结构异常；（2）心腔大小、瓣膜狭窄和心包积液得到了准确评估；（3）超声听诊器无法用于检测瓣膜反流；（4）其局限性包括缺乏冻结帧、M型、硬拷贝和多普勒功能。
