EchoScopy in Scanning Abdominal Diseases: Initial Clinical Experience

Abstract

Background and Aims: The introduction of a new type of small handheld ultrasound device brings greater portability and affordability. The basic ultrasound approach with these handheld devices has been defined by European Federation of Societies of Ultrasound in Medicine and Biology (EFSUMB) as “EchoScopy”. The current study aimed to assess the image quality, indications and limitations of a portable pocket “EchoScope” compared with a high-end ultrasound system in abdominal diseases.

Methods: 231 consecutive patients were included in this study. Physician A performed ultrasound examinations with a high-end ultrasound system (HEUS), then physician B performed the same ultrasound examination using an EchoScope (Vscan™). In patients with focal lesions, physician B also measured the largest diameters and graded the vascularity by using colour Doppler imaging (CDI) within the lesion on the same plane with both ultrasound systems. Compared with the excellent image quality using HEUS, the image quality of the EchoScope was graded as good, sufficient or non-sufficient.

Results: Out of all 231 patients, 167 had focal lesions, 19 patients were found with diffuse pathological findings, six with ascites, six after liver puncture and 33 without any pathological findings. The image quality of the pocket device was considered as being good or sufficient to delineate the pathology in 225/231 (97.4 %). The detection rate of the EchoScope for abdominal focal lesion was 162/167 (97 %), only five superficially located lesions could not be detected. Both systems showed agreement in determination of the best positioning to perform abdominal paracentesis and assessing complications after intervention.

Conclusions: The investigated EchoScope displays a sufficient image quality, in some indications such as detection of focal lesions > 20 mm, detection of ascites, hydronephrosis and other pathological findings with comparable results to HEUS. We conclude that pocket sized EchoScopy devices have a promising future but the indications have to be determined by a prospective study.

Zusammenfassung

Einleitung: Die Einführung portabler Ultraschalleinheiten ermöglicht eine flexible Durchführung von Ultraschalluntersuchungen. Die EFSUMB (European Federation of Societies of Ultrasound in Medicine and Biology) definierte dieses Vorgehen als „EchoScopy“. Aktuell ist die Vscan™ (GE Healthcare) als kleinste verfügbare Ultraschalleinheit. Das Ziel der vorliegenden Studie war es, die Bildqualität, mögliche Indikationen und Limitationen des portablen „Echoskops“ zu untersuchen und mit einem Standard-Ultraschallsystem zu vergleichen.

Methoden: 231 Patienten wurden eingeschlossen. Untersucher A führte zunächst eine Abdomen-Ultraschalluntersuchung mit einen High-End-Standardgerät (HEUS) durch. Anschließend erfolgte die gleiche Untersuchung mithilfe des Vscan™ durch Untersucher B. Verglichen wurden Messgrößen und Vaskularisationsgrad mittels Farbdoppler. Die mit Vscan™ erhaltenen Ultraschallbilder wurden hinsichtlich ihrer Qualität mit denen des Standardgeräts verglichen und als gut, ausreichend und unzureichend gewertet.

Ergebnisse: Bei 167/231 Patienten waren fokale Läsionen nachweisbar, 19 Patienten zeigten diffuse Pathologika, 6 Patienten hatten Aszites und bei weiteren 6 Patienten war eine Leberpunktion erfolgt. Bei 33 Patienten konnte kein pathologischer Befund gefunden werden. Die Bildqualität des tragbaren Ultraschallsystems war gut oder ausreichend bei 225/231 (97,4 %) der Patienten. Die Detektionsrate des Vscans™ für den Nachweis von fokalen Läsionen betrug 162/167 (97 %). Fünf oberflächennah gelegene Läsionen konnten mit dem tragbaren Gerät nicht nachgewiesen werden. Eine gute Korrelation fand sich bei dem Vergleich Größenbestimmung (r = 0,985, p< 0,001). Bei 152/162 (93,8 %) der Läsionen war der Vaskularisationsgrad übereinstimmend.

Zusammenfassung: Das Echoskop zeigt in den meisten Fällen eine ausreichende Bildqualität (B-Bild, Farbdoppler) und übereinstimmende Untersuchungsergebnisse. Oberflächlich gelegene Pathologika und onkologische Fragestellungen lassen sich allerdings nicht ausreichend beantworten.

Key words

liver - tumour - neoplasia - mobile ultrasound

Schlüsselwörter

Leber - Tumor - Neoplasie - mobiler Ultraschall

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