自动化 3D 超声使新手用户能够以与经过培训的超声医师使用传统双功能超声相当的准确性测量动静脉瘘成熟参数：一项台架研究的结果。
Automated 3D ultrasound enables novice users to measure arteriovenous fistula maturation parameters with comparable accuracy to conventional duplex by trained sonographers: Results of a benchtop study.
机构信息
Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Departments of Medicine and Population Health Sciences, University of Wisconsin Schools of Medicine and Public Health, Madison, WI, USA.
出版信息
J Vasc Access. 2023 Nov;24(6):1398-1406. doi: 10.1177/11297298221074462. Epub 2022 Mar 8.
BACKGROUND
Arteriovenous fistulae (AVF) are considered the preferred hemodialysis access but up to 50% of all AVF created in the United States never mature. Doppler ultrasound (DUS) is useful for predicting fistula maturity and impending fistula failure. DUS is resource-intensive and is associated with poor compliance rates in dialysis patients, ranging from 12% to 33%.
METHODS
EchoSure is an FDA-cleared 3D Doppler ultrasound device that automatically delivers quantitative blood flow and anatomic vascular information. The technology can be used at the bedside by personnel without formal sonographic training, nullifying limitations of traditional Duplex ultrasound imaging. This study compared the EchoSure system in the hands of inexpert personnel to a traditional expert-operated DUS for rapid assessment of a benchtop model vascular system with flow, diameter, and depth expected in a human AVF.
RESULTS
Both Duplex and EchoSure performed within the expected tolerance of ultrasound readings (35%) for volume flow, with the average error (AE) between the observed measurement and the ground truth being 8% for Duplex and 8% for EchoSure. However, the average coefficient of variation (CV) for Duplex pooled over all flow rate measurements was 17% versus 4% for EchoSure. Regarding diameter, Duplex measurements had AE of 15% with an average CV of 6% across all measurements versus EchoSure AE of 4% and average CV of 2%. Duplex and EchoSure measurements over all depths had the same AE of 2%. The two modalities were not statistically different for depth measurement ( = 0.05) but EchoSure measured closer to the ground truth for flow rate and vessel diameter (flow: = 0.028, = -0.07; diameter: p < 0.001, = 0.69). The inexpert personnel using EchoSure acquired data 62% faster than the expert sonographers using the Duplex ultrasound (141 min for Duplex vs 87 min for EchoSure).
CONCLUSIONS
EchoSure may offer an accurate and convenient alternative for imaging fistulas in the clinic.
背景
动静脉瘘（AVF）被认为是首选的血液透析通路，但在美国创建的所有 AVF 中，多达 50%从未成熟。多普勒超声（DUS）可用于预测瘘管成熟度和即将发生的瘘管失败。DUS 资源密集型，与透析患者的依从率低有关，范围为 12%至 33%。
方法
EchoSure 是一种获得 FDA 批准的 3D 多普勒超声设备，可自动提供定量血流和解剖血管信息。该技术可由未经正式超声培训的人员在床边使用，消除了传统双功能超声成像的限制。这项研究比较了不熟练人员使用的 EchoSure 系统与传统专家操作的 DUS，用于快速评估具有预计在人体 AVF 中出现的流量、直径和深度的台式血管系统。
结果
Duplex 和 EchoSure 均在超声读数（35%）的预期容差范围内进行体积流量，Duplex 和 EchoSure 的观察测量值与真实值之间的平均误差（AE）分别为 8%和 8%。然而，Duplex 的平均变异系数（CV）在所有流速测量中为 17%，而 EchoSure 为 4%。关于直径，Duplex 测量值的 AE 为 15%，所有测量值的平均 CV 为 6%，而 EchoSure 的 AE 为 4%，平均 CV 为 2%。Duplex 和 EchoSure 在所有深度的测量值相同的 AE 为 2%。两种方式在深度测量上没有统计学差异（ = 0.05），但 EchoSure 更接近流量和血管直径的真实值（流量： = 0.028， = -0.07；直径：p < 0.001， = 0.69）。使用 EchoSure 的非熟练人员获取数据的速度比使用 Duplex 超声的专家超声医师快 62%（Duplex 为 141 分钟，EchoSure 为 87 分钟）。
结论
EchoSure 可为诊所中的瘘管成像提供准确便捷的替代方案。
Zotero 插件