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基于 5G 的远程超声机器人系统为农村岛屿上的患者提供合格的腹部超声服务:一项前瞻性对比研究,纳入 401 例患者。

A 5G-based telerobotic ultrasound system provides qualified abdominal ultrasound services for patients on a rural island: a prospective and comparative study of 401 patients.

机构信息

Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China.

Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, 200072, China.

出版信息

Abdom Radiol (NY). 2024 Mar;49(3):942-957. doi: 10.1007/s00261-023-04123-5. Epub 2023 Dec 15.

Abstract

PURPOSE

To explore the feasibility of a 5G-based telerobotic ultrasound (US) system for providing qualified abdominal US services on a rural island.

METHODS

This prospective study involved two medical centers (the tele-radiologist site's hospital and the patient site's hospital) separated by 72 km. Patients underwent 5G-based telerobotic US by tele-radiologists and conventional US by on-site radiologists from September 2020 to March 2021. The clinical feasibility and diagnostic performance of the 5G-based telerobotic abdominal US examination were assessed based on safety, duration, image quality, diagnostic findings, and questionnaires.

RESULTS

A total of 401 patients (217 women and 184 men; mean age, 54.96 ± 15.43 years) were enrolled. A total of 90.1% of patients indicated no discomfort with the telerobotic US examination. For the examination duration, telerobotic US took longer than conventional US (12.54 ± 3.20 min vs. 7.23 ± 2.10 min, p = 0.001). For image quality scores, the results of the two methods were similar (4.54 ± 0.63 vs. 4.57 ± 0.61, p = 0.112). No significant differences were found between the two methods in measurements for the aorta, portal vein, gallbladder, kidney (longitudinal diameter), prostate, and uterus; however, telerobotic US underestimated the transverse diameter of the kidney (p < 0.05). A total of 504 positive results, including 31 different diseases, were detected. Among them, 455 cases were identified by the two methods; 17 cases were identified by telerobotic US only; and 32 cases were identified by conventional US only. There was good consistency in the diagnosis of 29 types of disease between the two methods (κ = 0.773-1.000). Furthermore, more than 90% of patients accepted the telerobotic US examination and agreed to pay additional fees in future.

CONCLUSION

The 5G-based telerobotic US system can expand access to abdominal US services for patients in rural areas, thereby reducing health care disparities.

摘要

目的

探索基于 5G 的远程机器人超声(US)系统在偏远岛屿上提供合格的腹部 US 服务的可行性。

方法

本前瞻性研究涉及两个医疗中心(远程放射科医师站点的医院和患者站点的医院),两地相距 72 公里。2020 年 9 月至 2021 年 3 月,患者接受远程放射科医师的基于 5G 的远程机器人 US 和现场放射科医师的常规 US。基于安全性、持续时间、图像质量、诊断结果和问卷调查来评估基于 5G 的远程机器人腹部 US 检查的临床可行性和诊断性能。

结果

共纳入 401 例患者(217 例女性和 184 例男性;平均年龄,54.96±15.43 岁)。90.1%的患者表示对远程机器人 US 检查无不适。对于检查持续时间,远程机器人 US 比常规 US 长(12.54±3.20min 比 7.23±2.10min,p=0.001)。对于图像质量评分,两种方法的结果相似(4.54±0.63 比 4.57±0.61,p=0.112)。两种方法在测量主动脉、门静脉、胆囊、肾脏(长径)、前列腺和子宫方面无显著差异;然而,远程机器人 US 低估了肾脏的横径(p<0.05)。共检测到 504 个阳性结果,包括 31 种不同的疾病。其中,两种方法均能识别 455 例;远程机器人 US 仅能识别 17 例;常规 US 仅能识别 32 例。两种方法对 29 种疾病的诊断一致性较好(κ=0.773-1.000)。此外,超过 90%的患者接受了远程机器人 US 检查,并同意在未来支付额外费用。

结论

基于 5G 的远程机器人 US 系统可以扩大农村地区患者接受腹部 US 服务的机会,从而减少医疗保健差距。

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