Mitchell Lee1, J Mark Roberts1, Luke Chen1, Silvia Chang1, Rose Hatala1, Kevin W Eva1, Graydon S Meneilly2. 1. Departments of Medicine (M.L., J.M.R., L.C., R.H., K.W.E, G.S.M.) and Radiology (S.C.) and Center for Health Education Scholarship (R.H., K.W.E.), Vancouver Hospital and University of British Columbia, Vancouver, British Columbia, Canada. 2. Departments of Medicine (M.L., J.M.R., L.C., R.H., K.W.E, G.S.M.) and Radiology (S.C.) and Center for Health Education Scholarship (R.H., K.W.E.), Vancouver Hospital and University of British Columbia, Vancouver, British Columbia, Canada. meneilly@mailubc.ca.
Abstract
OBJECTIVES: Physical examination can identify palpable splenomegaly easily, but evaluating lesser degrees of splenomegaly is problematic. Hand-carried ultrasound allows rapid bedside assessment of patients. We conducted this study to determine whether hand-carried ultrasound can reliably assess spleen size. METHODS: Patients with varying degrees of splenomegaly were studied. Two sonographers blindly measured spleen size in each patient using either a hand-carried or conventional ultrasound device in random order. Sonographers completed a data sheet indicating the adequacy of the image, clinical measurements of enlargement, and confidence in their observations. RESULTS: Sixteen patients (10 male and 6 female; mean age ± SEM, 60 ± 4 years) were recruited. Image quality was adequate or better in all scans with conventional ultrasound and in 15 of 16 scans with hand-carried ultrasound. The greatest longitudinal measurement recorded was statistically equivalent across ultrasound techniques, with mean values of 16.4 cm (95% confidence interval, 14.8-18.0 cm) for conventional ultrasound and 15.8 cm (95% confidence interval, 14.1-17.4 cm) for hand-carried ultrasound. The correlation between measurement techniques was r = 0.89 (P < .0001). Sonographers were somewhat or very confident in the outcomes of all scans with conventional ultrasound and in 15 of 16 cases with hand-carried ultrasound. In general, it took longer for sonographers to obtain images with hand-carried ultrasound. CONCLUSIONS: We have shown that hand-carried ultrasound can be used at the point of care by trained individuals to diagnose splenomegaly. However, hand-carried ultrasound images were less likely to be judged excellent, were accompanied by less diagnostic certainty, and took longer to obtain.
OBJECTIVES: Physical examination can identify palpable splenomegaly easily, but evaluating lesser degrees of splenomegaly is problematic. Hand-carried ultrasound allows rapid bedside assessment of patients. We conducted this study to determine whether hand-carried ultrasound can reliably assess spleen size. METHODS:Patients with varying degrees of splenomegaly were studied. Two sonographers blindly measured spleen size in each patient using either a hand-carried or conventional ultrasound device in random order. Sonographers completed a data sheet indicating the adequacy of the image, clinical measurements of enlargement, and confidence in their observations. RESULTS: Sixteen patients (10 male and 6 female; mean age ± SEM, 60 ± 4 years) were recruited. Image quality was adequate or better in all scans with conventional ultrasound and in 15 of 16 scans with hand-carried ultrasound. The greatest longitudinal measurement recorded was statistically equivalent across ultrasound techniques, with mean values of 16.4 cm (95% confidence interval, 14.8-18.0 cm) for conventional ultrasound and 15.8 cm (95% confidence interval, 14.1-17.4 cm) for hand-carried ultrasound. The correlation between measurement techniques was r = 0.89 (P < .0001). Sonographers were somewhat or very confident in the outcomes of all scans with conventional ultrasound and in 15 of 16 cases with hand-carried ultrasound. In general, it took longer for sonographers to obtain images with hand-carried ultrasound. CONCLUSIONS: We have shown that hand-carried ultrasound can be used at the point of care by trained individuals to diagnose splenomegaly. However, hand-carried ultrasound images were less likely to be judged excellent, were accompanied by less diagnostic certainty, and took longer to obtain.
Authors: Moses Laman; Susan Aipit; Cathy Bona; Peter M Siba; Leanne J Robinson; Laurens Manning; Timothy M E Davis Journal: Malar J Date: 2015-05-28 Impact factor: 2.979
Authors: Ignacio Manuel Sánchez Barrancos; Francisco José Guerrero García; María Del Carmen Rico López; Vicente Fernández Rodríguez; Tomás Vegas Jiménez; Rafael Alonso Roca; Daniel Domínguez Tristancho Journal: Aten Primaria Date: 2018-05-30 Impact factor: 1.137