Hill Garick D, Hahn Eunice, Block Joseph R, Chaves Alicia H, Cumbermack Kristopher, Lipinski Joan, Natarajan Shobha, Parra David A, Robinson Joshua D, Soriano Brian D, Walsh Michael J, Seo JangDong, Frommelt Peter
Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Pediatr Cardiol. 2024 Dec 31. doi: 10.1007/s00246-024-03763-8.
No method of evaluating transthoracic echocardiograms (TTE) image quality (IQ) has been validated. Furthermore, structural echo lab elements impacting IQ are unknown. We sought to develop and validate a TTE IQ grading tool and determine patient and echo lab features associated with IQ. Ten pediatric echo labs each submitted 50 consecutive new patient TTEs without complex heart disease. For each study, 3 sonographers independently rated IQ and performed routine measurements. IQ scoring used the American College of Cardiology Quality Network (ACC QNet) tool plus a novel Likert scale component. IQ scores were validated against the ability to make measurements and, when all measurements were made, variation between sonographers. After validation, patient and lab factors, from a previously published survey, associated with improved TTE IQ were determined by linear regression. Total IQ score (R = 0.64), ACC QNet (R = 0.29) and the Likert component (R = 0.52) correlated with the total number of measurements made (p < 0.001). For the 236 (52%) TTEs with all measurements, the Likert scale component (OR 0.9, 95% CI 0.82-0.99, p = 0.037) was associated with lower measurement variability. Factors significantly associated with worse IQ scores were higher patient weight, performance by a traveling sonographer, lower annual and inpatient TTE volume, less dedicated teaching/administrative sonographer time, and full-day sessions for reading physicians. A novel TTE IQ scoring tool was created and validated for pediatric TTE. Modifiable structural components of echo labs associated with TTE IQ were identified. This novel IQ tool should guide IQ beyond the ACC QNet score.
目前尚未有评估经胸超声心动图（TTE）图像质量（IQ）的方法得到验证。此外，影响图像质量的超声心动图实验室结构要素尚不清楚。我们试图开发并验证一种TTE图像质量分级工具，并确定与图像质量相关的患者和超声心动图实验室特征。十家儿科超声心动图实验室各自连续提交了50例无复杂心脏病的新患者TTE检查结果。对于每项研究，3名超声检查人员独立评估图像质量并进行常规测量。图像质量评分采用美国心脏病学会质量网络（ACC QNet）工具加上一个新的李克特量表部分。根据测量能力以及在完成所有测量时超声检查人员之间的差异对图像质量评分进行验证。验证后，通过线性回归确定先前发表的调查中与TTE图像质量改善相关的患者和实验室因素。总图像质量评分（R = 0.64）、ACC QNet评分（R = 0.29）和李克特量表部分（R = 0.52）与所进行测量的总数相关（p < 0.001）。对于所有测量均完成的236例（52%）TTE检查，李克特量表部分（比值比0.9，95%置信区间0.82 - 0.99，p = 0.037）与较低的测量变异性相关。与较差图像质量评分显著相关的因素包括患者体重较高、由流动超声检查人员进行检查、年度和住院患者TTE检查量较低、专门用于教学/行政工作的超声检查人员时间较少以及医生全天阅片。创建并验证了一种用于儿科TTE的新型图像质量评分工具。确定了与TTE图像质量相关的超声心动图实验室可改变结构要素。这种新型图像质量工具应在ACC QNet评分之外指导图像质量评估。
