Diagnostic Accuracy of a Hand-Held Ultrasound Scanner in Routine Patients Referred for Echocardiography

• Published in: Journal of the American Society of Echocardiography Vol. 24; no. 2; pp. 111 - 116
• Main Authors: Prinz, Christian, MD, Voigt, Jens-Uwe, MD
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.02.2011
• Subjects: Adult; Aged; Aged, 80 and over; Cardiovascular; Echocardiography; Echocardiography - instrumentation; Equipment Design; Equipment Failure Analysis; Female; Hand-held ultrasound scanner; Humans; Image quality; Male; Middle Aged; Miniaturization; Point-of-Care Systems; Referral and Consultation; Reproducibility of Results; Sensitivity and Specificity; Single-Blind Method; Ventricular Dysfunction, Left - diagnostic imaging; Vscan; Image quality; EF; Vscan; Echocardiography; Handheld ultrasound; HIGH; Left ventricular; Hand-held ultrasound scanner; LV; High-end echocardiography; HAND; Ejection fraction
• ISSN: 0894-7317; 1097-6795
• DOI: 10.1016/j.echo.2010.10.017

Background The aim of this study was to investigate the imaging capabilities of recent hand-held ultrasound scanners. Methods Three hundred forty-nine patients were scanned with hand-held ultrasound (HAND) and high-end echocardiography (HIGH). Segmental endocardial border delineation was scored (2 = good, 1 = poor, 0 = invisible) to describe image quality. Assessments of left ventricular (LV) dimensions, regional and global LV function, and grades of valve disease were compared. Results The mean endocardial visibility grades were 1.6 ± 0.5 with HAND and 1.7 ± 0.4 with HIGH ( P < .01). Regional wall motion was scored very similarly (κ = 0.73, P < .01). Ejection fraction assessment (bias = 1.8%, 1.96 × SD = 8.3%) and LV measurements ( r = 0.99, P < .01; interventricular septum: bias = 0.91 mm, 1.96 × SD = 2.1 mm; LV end-diastolic diameter: bias = 0.5 mm, 1.96 × SD = 4.1 mm; LV posterior wall: bias = 0.61 mm, 1.96 × SD = 2.4 mm) showed negligible deviations. No pericardial effusion or valve stenosis was missed. Regurgitations missed by HAND were all graded “minimal” on HIGH. Regurgitations were mildly overestimated by HAND. Overall concordance for detection of regurgitations was very good (κ = 0.9, P < .01). Conclusions Handheld echocardiography was feasible and missed no relevant findings. Given the future implementation of spectral Doppler capabilities, this handheld scanner can safely be used in clinical routine.