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Advanced Ultrasound in Diagnosis and Therapy ›› 2024, Vol. 8 ›› Issue (3): 116-123.doi: 10.37015/AUDT.2023.230046

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  • 收稿日期:2023-09-16 修回日期:2023-11-28 接受日期:2023-12-12 出版日期:2024-09-30 发布日期:2024-10-16

Can Different Expertise Levels of Ultrasound Operators Accurately Screen with Handheld Ultrasound?

Yuzhou Shen, MDa,1, Lin Jin, MDb,1, Lei Sha, MDc, Mengmeng Cao, MDc, Desheng Sun, MDa, Li Liu, MDa,*(), Zhaojun Li, MDc,d,*()   

  1. aDepartment of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
    bDepartment of Ultrasound, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
    cDepartment of Ultrasound, Shanghai General Hospital Jiading Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China
    dDepartment of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
  • Received:2023-09-16 Revised:2023-11-28 Accepted:2023-12-12 Online:2024-09-30 Published:2024-10-16
  • Contact: *Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, 100 Haining Road, Hongkou District, Shanghai 200080, China. e-mail: lzj_1975@sina.com(LZJ); Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China e-mail: liuli126126@126.com(LL)
  • About author:First author contact:

    1Yuzhou Shen and Lin Jin contributed equally to this work.

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Abstract:

Objective: To evaluate accuracy and feasibility of a handheld ultrasound machine for measuring carotid artery intima-media thicknesses (CIMT) and hemodynamic parameters by different expertise levels of ultrasound operators.

Methods: The operators were divided into three groups based on the level of their medical expertise: ultrasound technician, sonographer, and nursing staff. Operators from each group measured the CIMT and hemodynamic parameters of 25 volunteers using both handheld ultrasound and a conventional ultrasound machine. The reliability and reproducibility of handheld ultrasound measurements of CIMT and hemodynamic parameters (peak systolic velocity (PSV), end-diastolic velocity (EDV)) in operators were analyzed.

Results: After a period of training, there was no statistically significant difference between the mean CIMT measured using handheld ultrasound among the three operators (0.45 ± 0.09 mm, 0.50 ± 0.07 mm, 0.46 ± 0.08 mm, P> 0.05, respectively), as well as PSV (83.30 ± 15.42 cm/s, 76.28 ± 13.26 cm/s, 81.12 ± 21.21 cm/s, P> 0.05, respectively) and EDV (21.04 ± 4.12 cm/s, 21.87 ± 5.05 cm/s, 20.17 ± 5.90 cm/s, respectively, P> 0.05). Furthermore, there was a good repeatability and consistent of handheld ultrasound device in measuring mean CIMT in the ultrasound technician and sonographer groups (r = 0.662, 0.691, respectively, P < 0.01).

Conclusions: Under the premise of proper training, handheld ultrasound systems are feasible for rapid and primary assessment of carotid artery by operators with different levels of expertise.

Key words: Handheld ultrasound, Conventional ultrasound, Carotid artery, Intima-media

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Item Nursing staff group Sonographer group Technician group P value
Max IMT (mm) 0.54 ± 0.07 0.54 ± 0.07 0.54 ± 0.09 0.893
Mean IMT (mm) 0.44 ± 0.06 0.46 ± 0.07 0.44 ± 0.07 0.515
PSV (cm/s) 66.94 ± 14.12 78.88 ± 10.93* 82.30 ± 14.32* < 0.001
EDV (cm/s) 21.73 ± 4.11 25.38 ± 3.39* 24.66 ± 3.43* 0.003
Pulsatility index 1.74 ± 0.94 1.36 ± 0.21 1.47 ± 0.29 0.373
Resistive index 0.76 ± 0.24 0.68 ± 0.04 0.70 ± 0.04 0.284
Systolic-diastolic ratio 3.11 ± 0.56 3.12 ± 0.42 3.36 ± 0.49 0.141
ACCEL (cm/s2) 665.97 ± 350.53 680.08 ± 188.14 859.50 ± 254.27*# 0.016
Acceleration time (s) 0.09 ± 0.05 0.08 ± 0.02 0.07 ± 0.02 0.059
TAMEAN (cm/s) 18.84 ± 5.12 24.70 ± 3.67* 25.67 ± 5.14* < 0.001
Heart rate (bpm) 71.40 ± 12.41 71.52 ± 8.25 74.60 ± 10.30 0.414

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Item Nursing staff group Sonographer group Technician group P value
Max IMT (mm) 0.47 ± 0.08 0.52 ± 0.07 0.46 ± 0.09# 0.047
Mean IMT (mm) 0.46 ± 0.08 0.50 ± 0.07 0.45 ± 0.09 0.067
PSV (cm/s) 81.12 ± 21.21 76.28 ± 13.26 83.30 ± 15.42 0.357
EDV (cm/s) 20.17 ± 5.90 21.87 ± 5.05 21.04 ± 4.12 0.164
Pulsatility index 1.76 ± 0.45 1.52 ± 0.30* 1.75 ± 0.37# 0.028
Resistive index 0.75 ± 0.07 0.71 ± 0.05 0.74 ± 0.05 0.057
Systolic-diastolic ratio 4.67 ± 2.44 3.54 ± 0.52* 4.06 ± 0.85# 0.033
ACCEL (cm/s2) 699.72 ± 281.14 625.16 ± 147.76 712.64 ± 212.7 0.449
Acceleration time (s) 0.10 ± 0.03 0.09 ± 0.01 0.09 ± 0.02 0.404
TAMEAN (cm/s) 21.78 ± 6.07 23.98 ± 4.85 23.14 ± 4.30 0.161
Heart rate (bpm) 73.12 ± 8.96 72.80 ± 8.47 75.08 ± 9.72 0.750

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Items Depth Conventional ultrasound Handheld ultrasound t value P value
Longitudinal resolution (mm) 2 cm 1.01 ± 0.03 1.01 ± 0.02 -0.111 0.919
3 cm 0.99 ± 0.01 0.99 ± 0.02 1.000 0.391
4 cm 1.00 ± 0.04 1.01 ± 0.03 -0.812 0.476
5 cm 0.99 ± 0.03 1.00 ± 0.03 -2.449 0.092
Lateral resolution (mm) 2 cm 4.18 ± 0.10 4.20 ± 0.08 -0.397 0.718
3 cm 4.13 ± 0.10 4.18 ± 0.10 -0.775 0.495
4 cm 4.18 ± 0.13 4.05 ± 0.19 0.243 0.824
5 cm 4.10 ± 0.08 4.12 ± 0.13 -0.264 0.809
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