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

doi:10.37015/AUDT.2023.230046

Abstract

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

Yuzhou Shen, MD, Lin Jin, MD, Lei Sha, MD, Mengmeng Cao, MD, Desheng Sun, MD, Li Liu, MD, Zhaojun Li, MD. Can Different Expertise Levels of Ultrasound Operators Accurately Screen with Handheld Ultrasound?. Advanced Ultrasound in Diagnosis and Therapy, 2024, 8(3): 116-123.

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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

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

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