在心脏科门诊患者中使用便携式心脏超声装置的评价

作     者：Vourvouri E.C. Poldermans D. Deckers J.W. J.R.T.C. Roelandt 赵登峰 

作者机构：Dr. Department of Cardiology Thoraxcentre-H 538 Erasmus MC Dr Molewaterplein 40 3015 GD Rotterdam Netherlands 

出 版 物：《世界核心医学期刊文摘（心脏病学分册）》 (Digest of the World Core Medical Journals(Cardiology))

年 卷 期：2005年第1卷第7期

页      面：26-26页

学科分类：0831[工学-生物医学工程（可授工学、理学、医学学位）] 100207[医学-影像医学与核医学] 1002[医学-临床医学] 08[工学] 1010[医学-医学技术（可授医学、理学学位）] 10[医学] 

主　　题：心脏科 临床诊断 漏诊率 盲法 内科专家 

摘      要：Objective: To determine the diagnostic potential of a hand carried cardiac ultrasound(HCU) device(OptiGo, Philips Medical Systems) in a cardiology outpatient clinic and to compare the HCU diagnosis with the clinical diagnosis and diagnosis with a full featured standard echocardiography(SE) system. Methods: 300 consecutive patients took part in the study. The HCU examination was performed by an experienced echocardiographer before patients visited the cardiologist. The echocardiographer noted whether the HCU device was able to confirm or reject the referral diagnosis, which abnormality was detected, and whether SE investigation was necessary. Physical examination by a cardiologist followed and thereafter, whenever required, a complete study with an SE was carried out. The HCU data were compared with the clinical diagnosis of the cardiologist and the SE diagnosis in a blinded manner. Results: The cardiologist referred 203 of 300 patients for an SE study and 13 patients for transoesophageal echocardiography. In 84 patients no further examination was considered necessary. HCU echocardiography was able to confirm or reject the suspected clinical diagnosis in 159 of 203(78%) patients. In 44 of 203(22%) patients SE Doppler was needed. Agreement between the HCU device and the SE system for the detection of major abnormalities was excellent(98%). The HCU device missed 4%of the major findings. Among the 84 patients not referred for an SE, the HCU device detected unsuspected major abnormalities missed with the physical examination in 14(17%). Conclusion: Integration of an HCU device with the physical examination augments the yield of information.