Australasian Journal of Ultrasound in Medicine最新文献_第4页

Ultrasound as a Diagnostic Tool in Detection of Maxillofacial Fractures at Level 1 Trauma Centre ED in India 超声在印度一级创伤中心ED检测颌面部骨折的诊断工具

Q3 Medicine

Australasian Journal of Ultrasound in Medicine

Pub Date : 2025-03-14 DOI: 10.1002/ajum.70001

Afroz Fatima, Priyanka Modi, Tej Prakash Sinha, Sanjeev Bhoi, Atin Kumar, Sushma Sagar

Background

Injuries, especially maxillofacial fractures, pose a significant global health burden exacerbated by increasing traffic activities. Early detection is vital for preventing complications. This study assesses ultrasound's diagnostic efficacy, aiming to improve patient management and minimise treatment delays by detecting maxillofacial fractures promptly and accurately.

Objective

The main aim was to assess point-of-care ultrasound (POCUS) in diagnosing maxillofacial fractures against computed tomography (CT) scans. Secondary goals included identifying ocular injuries, mandibular fractures, assessing probe feasibility and comparing Le Fort classification via ultrasound and CT.

Methodology

Between January 2019 and February 2021, 150 trauma patients (136 male) with a mean age of 28.5 ± 5 years (range, 18–62 years) suspected of maxillofacial fractures were enrolled. A trained physician performed facial ultrasound, and findings were documented alongside CT scan results. Using the SPSS software, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of POCUS against CT scans were analysed.

Results

Among 150 patients, CT scans diagnosed 137 with maxillofacial fractures, primarily due to road traffic accidents. Zygomatic fractures were most common, followed by nasal bone and mandibular parasymphysial fractures. POCUS exhibited high sensitivity (98.9%), specificity (99.1%), PPV (92%), and NPV (99.8%) for overall facial fractures, varying by bone. Associated occult ocular injuries occurred in two patients. Sensitivity and specificity were high for mandibular fractures. 5–10 MHz frequency linear probe, footprint-50 mm was optimal for midfacial bones, but Le Fort fractures could not be reliably identified using ultrasound.

Conclusion

The study underscores the value of POCUS in the Emergency Department for detecting maxillofacial fractures, despite limitations such as anatomical challenges. POCUS showed high diagnostic accuracy, emphasising its potential in clinical practice, requiring further validation and exploration.

背景伤害，特别是颌面骨折，造成了严重的全球健康负担，而交通活动的增加加剧了这一负担。早期发现对预防并发症至关重要。本研究评估超声诊断的有效性，旨在通过及时准确地检测颌面部骨折，改善患者管理，最大限度地减少治疗延误。目的比较点护理超声（POCUS）与CT （computer tomography， CT）扫描对颌面部骨折的诊断价值。次要目标包括识别眼部损伤、下颌骨折、评估探头可行性、比较超声和CT Le Fort分类。方法2019年1月至2021年2月，纳入150例疑似颌面部骨折的创伤患者（136例男性），平均年龄28.5±5岁（18-62岁）。一位训练有素的医生进行了面部超声检查，并将检查结果与CT扫描结果一起记录下来。采用SPSS软件分析POCUS对CT扫描的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）及诊断准确性。结果在150例患者中，CT扫描诊断出137例颌面部骨折，主要由道路交通事故引起。颧骨骨折最常见，其次是鼻骨和下颌副膈骨骨折。POCUS对面部整体骨折的敏感性（98.9%）、特异性（99.1%）、PPV（92%）和NPV（99.8%）均较高，随骨不同而不同。2例患者发生隐蔽性眼损伤。该方法对下颌骨骨折的敏感性和特异性均较高。5-10 MHz频率线性探头，足迹-50 mm是面中骨的最佳选择，但Le Fort骨折不能可靠地使用超声识别。结论尽管存在解剖学上的局限性，但该研究强调了POCUS在急诊科检测颌面部骨折的价值。POCUS具有较高的诊断准确性，强调其在临床实践中的潜力，需要进一步的验证和探索。

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引用次数: 0

Ultrasound of the uterosacral ligaments: A reliability study for diagnosing endometriosis in Australian non-specialised medical imaging and radiology settings 子宫骶韧带超声：澳大利亚非专业医学成像和放射学诊断子宫内膜异位症的可靠性研究

Q3 Medicine

Australasian Journal of Ultrasound in Medicine

Pub Date : 2025-02-18 DOI: 10.1002/ajum.12420

Shae Maple, Eva Bezak, K Jane Chalmers, Nayana Parange

Introduction/Background

Uterosacral ligaments (USL) are the most common sites of endometriosis. Transvaginal ultrasound (TVS) demonstrates high diagnostic accuracy for endometriosis of the USLs using standardised technique and characterisations. While high accuracy and reproducibility is established with these techniques by well-trained professionals, the question still remains if these techniques are reproducible in general settings. This study aims to assess the intra and interobserver agreement of TVS characteristics of USLs, between experienced and less experienced examiners in an Australian general ultrasound imaging practice, where sonographers are required to perform ultrasound for endometriosis.

Methods

Forty-two patients, with and without known endometriosis, underwent ultrasound imaging of the USLs. Images were obtained of uterosacral ligaments and collated for interobserver survey. Six professional observers independently reviewed the images, classifying characteristics such as echogenicity, echotexture, contour, thickness, and presence of nodules. Interobserver reliability was assessed using Gwet's agreement coefficients (AC1), and the correlation between USL thickness and endometriosis was analyzed using Spearman's correlation.

Results

Interobserver agreement for detecting USL endometriosis was substantial (AC1 = 0.63), with an overall agreement of (0.65) for the seven USL characteristics. Intraobserver agreement ranged from moderate (0.60) to almost perfect (0.96). Experience did not significantly affect intraobserver reliability. A strong positive correlation was found between USL thickness and endometriosis (r = 0.7965, P < 0.01).

Conclusion

This study demonstrates high inter and intraobserver agreement among sonographers and radiologists in a general imaging department for identifying USL characteristics and diagnosing USL endometriosis. Both experienced and less experienced operators can reliably assess USLs Consistency was shown in identifying thickened uterosacral ligaments however, there is no consensus on where uterosacral ligament be measured. Even so, a thickened USL can prompt further extension of the pelvic scan to look for other endometriosis markers.

子宫骶韧带（USL）是子宫内膜异位症最常见的部位。经阴道超声（TVS）使用标准化的技术和特征，对USLs子宫内膜异位症的诊断准确性很高。虽然训练有素的专业人员利用这些技术建立了高精度和可重复性，但这些技术在一般情况下是否可重复的问题仍然存在。本研究旨在评估在澳大利亚一般超声成像实践中，超声医师需要对子宫内膜异位症进行超声检查，在经验丰富和经验不足的检查人员之间，usl的TVS特征在观察者内部和观察者之间的一致性。方法对42例有或无子宫内膜异位症的患者行超声检查。获得子宫骶韧带的图像，并整理供观察者间调查。六名专业观察员独立审查图像，分类特征，如回声性、回声纹理、轮廓、厚度和结节的存在。采用Gwet一致系数（AC1）评估观察者间信度，采用Spearman相关分析USL厚度与子宫内膜异位症的相关性。结果在USL子宫内膜异位症的检测上，观察者间的一致性是显著的（AC1 = 0.63）， 7个USL特征的总体一致性为（0.65）。观察者内部的一致性范围从中等（0.60）到几乎完全（0.96）。经验对观察者内部信度没有显著影响。USL厚度与子宫内膜异位症呈正相关（r = 0.7965, P < 0.01）。结论：本研究表明，超声医师和放射科医师在诊断USL特征和诊断USL子宫内膜异位症方面，在观察间和观察内的一致性很高。经验丰富和经验不足的操作人员都可以可靠地评估USLs，在识别增厚的子宫骶韧带方面显示出一致性，然而，对于子宫骶韧带的测量位置尚无共识。即便如此，增厚的USL可以提示进一步扩大盆腔扫描以寻找其他子宫内膜异位症标志物。

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引用次数: 0

Hepatic abscess caused by foreign body ingestion: A case report 误食异物致肝脓肿1例

Q3 Medicine

Australasian Journal of Ultrasound in Medicine

Pub Date : 2025-02-17 DOI: 10.1002/ajum.12422

Qingqing Li, Yujiang Liu

Introduction

Liver abscess is a common clinical condition caused by bacterial, fungal or parasitic infections, usually due to immunosuppression. In contrast, secondary liver abscesses are caused by specific factors such as foreign bodies, tumours, or appendicitis.

Methods

We admitted a patient with secondary liver abscess and found an intrahepatic foreign body after interventional drainage. Initially, a foreign body of medical origin was suspected, but after a multidisciplinary consultation, it was determined to be caused by a foodborne foreign body. Laparoscopic surgery was then chosen as the treatment.

Result

The liver abscess was caused by an alimentary foreign body, and the intrahepatic foreign body was identified as a fish bone measuring approximately 2.5 cm in length.

Discussion

Upon diagnosing either primary or secondary liver abscess, aggressive treatment of the abscess focus is essential. However, in cases of secondary liver abscess, addressing and removing the underlying cause is necessary for complete resolution. For patients with a previously healthy liver, comprehensive history-taking is crucial, and imaging studies play a significant role in diagnosis and treatment. Clinicians and radiologists should be vigilant for the possibility of foreign bodies, tumours, or unexpected intra-abdominal inflammation, regardless of the patient's history. When dealing with food-borne foreign bodies, endoscopic intervention should be considered first, followed by laparoscopy, and as a last resort, open surgery.

Conclusion

The diagnosis and treatment of liver abscess in clinical practice require a complete medical history and thorough imaging examinations. Ultrasound, as the initial imaging modality, allows real-time and dynamic observation of lesions. It is essential for ultrasonologists to consider the possibility of foreign body-induced liver abscess when diagnosing patients with liver abscess.

肝脓肿是一种常见的临床疾病，由细菌、真菌或寄生虫感染引起，通常是由于免疫抑制所致。相反，继发性肝脓肿是由特定因素引起的，如异物、肿瘤或阑尾炎。方法收治1例继发性肝脓肿患者，经介入引流后发现肝内异物。最初，怀疑是医学来源的异物，但经过多学科会诊后，确定是由食源性异物引起的。然后选择腹腔镜手术作为治疗方法。结果肝脓肿由消化道异物引起，肝内异物为长约2.5 cm的鱼骨。在诊断原发性或继发性肝脓肿时，积极治疗脓肿病灶是必不可少的。然而，在继发性肝脓肿的情况下，解决和消除根本原因是完全解决所必需的。对于先前肝脏健康的患者，全面的病史记录是至关重要的，影像学研究在诊断和治疗中起着重要作用。无论患者的病史如何，临床医生和放射科医生都应警惕异物、肿瘤或意外的腹腔炎症的可能性。在处理食源性异物时，应首先考虑内镜干预，其次是腹腔镜，最后采取开放手术。结论临床对肝脓肿的诊断和治疗需要完整的病史和彻底的影像学检查。超声作为最初的成像方式，可以实时、动态地观察病变。超声医师在诊断肝脓肿时，必须考虑异物诱发肝脓肿的可能性。

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引用次数: 0

An innovative hybrid training method for ultrasound in giant cell arteritis, polymyalgia rheumatica and large vessel vasculitis 一种创新的巨细胞动脉炎、风湿性多肌痛和大血管炎超声混合训练方法

Q3 Medicine

Australasian Journal of Ultrasound in Medicine

Pub Date : 2025-02-03 DOI: 10.1002/ajum.12417

Li-Ching Chew, Cassandra Hong, Bhaskar Dasgupta

We propose a novel hybrid physical and virtual training method, complemented by online learning, as an effective method to teach and acquire ultrasound skills. We aim to illustrate this through our experience with a remote ultrasound training module for giant cell arteritis scanning. The significance of this innovation is the ability to mitigate the challenges faced by ultrasound training during pandemic-times, including the need for physical distancing, group size limitation and overseas travel restrictions. Furthermore, the hybrid training provides an invaluable access to distant specialist cognitive and procedural expertise when conventional means may not be feasible. Although this form of ultrasound training has limitations, such as diminished face-to-face contact, we were able to resume training despite the unfavourable circumstances. By harnessing virtual technology for hands-on training, we can strive to reduce worldwide training inequalities, particularly in areas requiring highly specialised skills where expertise may not be available locally. Even as the world has moved out of ‘lockdown’, the pandemic has serendipitously provided novel ways of doing things; the lessons learnt here can be utilised for future hybrid training models, especially where hands-on experience is crucial.

我们提出了一种新的物理和虚拟混合训练方法，辅以在线学习，作为教授和获得超声技能的有效方法。我们的目的是说明这一点，通过我们的经验与远程超声训练模块巨细胞动脉炎扫描。这一创新的重要意义在于，它能够缓解大流行期间超声培训面临的挑战，包括保持身体距离的必要性、团体规模限制和海外旅行限制。此外，当传统方法可能不可行时，混合培训提供了宝贵的远程专家认知和程序专业知识。虽然这种形式的超声训练有局限性，比如减少面对面的接触，但我们能够在不利的情况下恢复训练。通过利用虚拟技术进行实践培训，我们可以努力减少世界范围内的培训不平等现象，特别是在需要高度专业化技能的领域，而当地可能无法获得专门知识。即使世界已经摆脱了“封锁”，这场大流行也意外地提供了新的做事方式；这里学到的教训可以用于未来的混合培训模式，特别是在实践经验是至关重要的。

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引用次数: 0

Ultrasonographic view of fluid bronchogram secondary to endobronchial obstruction: A case report 继发于支气管内梗阻的支气管积液声像图1例。

Q3 Medicine

Australasian Journal of Ultrasound in Medicine

Pub Date : 2025-01-09 DOI: 10.1002/ajum.12418

Yash Kedia, Nitesh Gupta, Rohit Kumar

Background

Ultrasound has become an important aspect of emergency medicine due to its wide availability and portability for bedside investigations. Understanding some important ultrasound findings can aid in diagnosis and management.

Key findings

We present a case of a 65-year-old smoker who presented with shortness of breath and hemoptysis and was in respiratory failure upon arrival in the emergency department. Bedside ultrasound demonstrated a fluid bronchogram, aiding the diagnosis of lung collapse secondary to endobronchial obstruction.

Discussion

Fluid bronchograms are seen on CT chest and ultrasonography as linear images corresponding to dilated bronchus, filled with mucus, distal to an endobronchial obstruction. They are characterised by anechoic, tubular structures, suggestive of fluid filled bronchi, over the hypoechogenic pulmonary parenchyma, and can be differentiated from blood vessels by the lack of Doppler signal. Ultrasonographic image of fluid bronchogram is very unique and can help to detect collapse secondary to endobronchial obstruction using point-of-care ultrasonography in emergency.

背景：由于超声检查的广泛性和便携性，超声检查已成为急诊医学的一个重要方面。了解一些重要的超声检查结果有助于诊断和治疗：我们介绍了一例 65 岁吸烟者的病例，该患者因呼吸急促和咯血前来就诊，到达急诊科时已出现呼吸衰竭。床旁超声检查显示支气管积液，有助于诊断支气管内膜阻塞导致的肺塌陷：讨论：胸部 CT 和超声波检查发现的液性支气管图是支气管内膜阻塞远端扩张、充满粘液的线性图像。其特点是在低回声的肺实质上出现无回声的管状结构，提示支气管内充满液体，可通过缺乏多普勒信号与血管相鉴别。液性支气管的超声图像非常独特，有助于在急诊中利用护理点超声检查发现继发于支气管内阻塞的塌陷。

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引用次数: 0

Application of the 2023 World Heart Federation guidelines for the echocardiographic diagnosis of rheumatic heart disease 2023年世界心脏联合会指南在风湿性心脏病超声心动图诊断中的应用

Q3 Medicine

Australasian Journal of Ultrasound in Medicine

Pub Date : 2025-01-09 DOI: 10.1002/ajum.12421

Jacqueline Williamson, Amelia McLeod, James Marangou, Bo Remenyi, Peter Morris, Gillian Whalley

Rheumatic heart disease remains prevalent in some regions of Australia and New Zealand. Echocardiography is the gold standard for detection and diagnosis using the 2023 World Heart Federation guidelines. The guidelines describe specific features of mitral and aortic valve morphology and define pathological regurgitation associated with RHD. The aim of this education piece was to assist cardiac sonographers and reporting specialists in the accurate detection, diagnosis, and classification of RHD findings. We present the echocardiographic features of RHD as defined by the 2023 WHF guidelines, including a poster summarising the individual criteria for diagnosis.

风湿性心脏病在澳大利亚和新西兰的一些地区仍然很普遍。超声心动图是使用2023年世界心脏联合会指南进行检测和诊断的金标准。该指南描述了二尖瓣和主动脉瓣形态的具体特征，并定义了与RHD相关的病理性反流。这篇教育文章的目的是帮助心脏超声医师和报告专家准确检测、诊断和分类RHD的发现。我们介绍了2023年WHF指南中定义的RHD的超声心动图特征，包括一张总结诊断标准的海报。

引用次数: 0

Anatomy – The foundation of ultrasound imaging 解剖学-超声成像的基础。

Q3 Medicine

Australasian Journal of Ultrasound in Medicine

Pub Date : 2024-12-26 DOI: 10.1002/ajum.12416

Gillian Whalley

<p>Ultrasound is <i>the</i> most accessible, and the most utilised, of all medical imaging. Miniaturisation has reduced the cost and the portability such that anatomical imaging is now available in places we would never have ventured in the past. Today, it is possible to image a growing fetus in the middle of desert with no wired electricity; or to image the chest of a sailor on a yacht in the middle of the ocean to identify whether they have a ruptured aortic aneurysm; or to determine the extent of internal bleeding of an injured soldier in the middle of a warzone; or to identify a child in a remote location that is suffering from rheumatic heart disease and needs life-preserving penicillin treatment. Diagnostic ultrasound should be available to everyone, and everywhere, but the image quality may not be the same, and we may be restricted to simple black and white anatomy.</p><p>Since my career with ultrasound began, we have moved from being able to image the anatomy in two dimensions with limited functional assessment, to three-dimensional moving images with blood flow measurement and tissue motion detection, to name but a few innovations. We use ultrasound beyond diagnosis, to predict prognosis and to plan treatment strategies, but the new wave of handheld transducers has brought us back to the beginning and reminds me that anatomy is key. The so much clinical information can be obtained from simple grey scale anatomical pictures. Anatomy remains the foundation of ultrasound imaging.</p><p>In this issue of AJUM, we are reminded that underlying anatomical knowledge is key to important clinical decisions. Ward <i>et al</i>.<span><sup>1</sup></span> use ultrasound to document the migration of the placental cord insertion during pregnancy and suggest that this should be routinely reported on antenatal ultrasound examinations.</p><p>Fenech <i>et al</i>.<span><sup>2</sup></span> present a detailed review article about anatomy and ultrasound appearances of femoral and saphenous veins, and their branches, and advocate for users to become familiar with the normal appearances in order that we may accurately identify abnormalities. The imaging of nerves is increasingly being utilised as a tool for nerve blockade. Ultrasound anatomical imaging is frequently used to assist procedures. and Zanfini <i>et al</i>.<span><sup>3</sup></span> present a series of over 500 intrathecal injections where ultrasound was used to help identity the injection site. Although intravenous access can be done without ultrasound imaging, would you want to ignore the benefits of improved precision with anatomical image guidance?</p><p>I, like many student sonographers, learned and refined my anatomical knowledge while looking at ultrasound images. I watch as newly qualified doctors remembering their anatomy as they look at an ultrasound screen. And increasingly, ultrasound is being applied in medical schools to supplement medical students' anatomy learning. Anatomy is the heart of

超声是所有医学成像中最容易获得、使用最多的。小型化降低了成本和便携性，使得解剖成像现在可以在我们过去从未冒险过的地方进行。今天，我们可以想象一个正在成长的胎儿在没有电线的沙漠中；或者在海洋中央的游艇上给水手的胸部拍照，以确定他们是否有破裂的主动脉瘤；或者在战区中确定受伤士兵的内出血程度；或者在偏远地区发现一个患有风湿性心脏病、需要青霉素治疗的孩子。诊断超声应该对每个人都可用，在任何地方，但图像质量可能不一样，我们可能仅限于简单的黑白解剖。自从我的超声职业生涯开始以来，我们已经从能够在有限的功能评估的二维解剖成像，发展到具有血流测量和组织运动检测的三维运动图像，仅举几例创新。我们在诊断之外使用超声波来预测预后和制定治疗策略，但新一波的手持换能器把我们带回到开始，提醒我解剖是关键。从简单的灰度解剖图像中可以获得如此多的临床信息。解剖学仍然是超声成像的基础。在本期《美国医学会杂志》中，我们被提醒，基础解剖学知识是重要临床决策的关键。Ward等人1使用超声记录妊娠期间胎盘脐带插入的移动，并建议这应在产前超声检查中常规报告。Fenech et al.2发表了一篇详细的关于股静脉和隐静脉及其分支的解剖和超声表现的综述文章，并提倡用户熟悉正常的外观，以便我们能够准确地识别异常。神经成像越来越多地被用作神经阻断的工具。超声解剖成像常用于辅助手术。和Zanfini等人3提出了一系列超过500次的鞘内注射，其中超声用于帮助识别注射部位。虽然静脉注射可以在没有超声成像的情况下进行，但你会想忽视解剖图像引导下提高精度的好处吗？我和许多学生超声医师一样，在看超声图像的过程中学习和完善了我的解剖学知识。我看着刚获得资格的医生在看超声波屏幕时记住他们的解剖结构。超声越来越多地应用于医学院，以补充医学生的解剖学学习。解剖是ASUM成员和AJUM读者每天使用超声的核心。

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引用次数: 0

Identifying enablers and barriers to teleultrasound use for remote settings: A scoping review 确定远程超声在偏远地区使用的促进因素和障碍：范围审查。

Q3 Medicine

Australasian Journal of Ultrasound in Medicine

Pub Date : 2024-12-13 DOI: 10.1002/ajum.12415

Aubree Anderson, Rebecca G Theophanous

Introduction/Purpose

Teleultrasound connects expert point-of-care ultrasound (POCUS) users with remote community and rural sites. Evolving technologies including handheld devices, upgraded image quality, and the ability to transmit over low bandwidth connections increase POCUS education, accessibility, and clinical integration. Potential teleultrasound venues include low-resource settings, prehospital care, and austere environments (high altitudes, microgravity, conflict zones, etc.). This scoping review assesses current teleultrasound uses and identifies implementation enablers and barriers.

Methods

Using the PRISMA-ScR checklist, PubMed, Embase, and Cochrane were searched on 16 August 2024 for teleultrasound studies. Two reviewers independently screened results and abstracted data using a data collection table. 165 articles met the following inclusion criteria: research studies describing teleultrasound, involving humans, including healthcare workers, with remote point-of-care or medical ultrasound use, in any setting, and in English.

Results

Teleultrasound studies were reported in most specialties and across all continents. Most were prospective (100 studies), review articles (27), or case studies (14). Study quality was variable, with 28 high quality, 77 moderate, 54 low, and 6 very low (GRADE assessment tool). Common themes that emerged include (1) type of image transmission method utilised, (2) remote provider training and curriculum development, (3) feedback methods between expert and novice users, (4) technologies and devices used, and (5) enablers and barriers to guide future teleultrasound implementation and training strategies.

Conclusion

Overall, the teleultrasound literature is heterogeneous in setting, design, and quality outcomes. As teleultrasound technology evolves and the use expands, future studies should standardise protocols and ensure image quality fidelity to optimise remote patient care.

介绍/用途：Teleultrasound将专家护理点超声（POCUS）用户与偏远社区和农村站点连接起来。包括手持设备、升级的图像质量和通过低带宽连接传输的能力在内的不断发展的技术增加了POCUS教育、可访问性和临床集成。潜在的远程超声场所包括低资源环境、院前护理和恶劣环境（高海拔、微重力、冲突地区等）。本范围审查评估了目前远程超声的使用，并确定了实施的推动因素和障碍。方法：使用PRISMA-ScR检查表，检索PubMed， Embase和Cochrane于2024年8月16日进行的远程超声研究。两名审稿人独立筛选结果并使用数据收集表提取数据。165篇文章符合以下纳入标准：描述远程超声的研究，涉及人类，包括卫生保健工作者，在任何环境下使用远程护理点或医疗超声，并以英语进行。结果：远程超声研究报告在大多数专业和所有大陆。大多数是前瞻性研究（100项研究）、综述性文章（27篇）或案例研究（14篇）。研究质量是可变的，28个高质量，77个中等质量，54个低质量，6个非常低质量（GRADE评估工具）。出现的共同主题包括(1)使用的图像传输方法类型，(2)远程提供者培训和课程开发，(3)专家和新手用户之间的反馈方法，(4)使用的技术和设备，以及(5)指导未来远程超声实施和培训策略的促成因素和障碍。结论：总体而言，远程超声文献在设置、设计和质量结果方面存在差异。随着远程超声技术的发展和应用的扩大，未来的研究应该标准化协议，确保图像质量的保真度，以优化远程患者护理。

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引用次数: 0

Ultrasound evaluation of peripheral intravenous catheter thrombus formation associated with intravenous flucloxacillin administration: A prospective observational pilot study 超声评价与氟氯西林静脉注射相关的外周静脉导管血栓形成：一项前瞻性观察性先导研究。

Q3 Medicine

Australasian Journal of Ultrasound in Medicine

Pub Date : 2024-11-27 DOI: 10.1002/ajum.12414

Andrew C. Bulmer, Rachael Nightingale, Wenu Hewage, Gerben Keijzers, Peter J. Snelling

Purpose

The purpose of this study was to sonographically evaluate whether intravenous (IV) flucloxacillin administration was associated with an increased risk of peripheral intravenous catheter (PIVC) thrombus formation.

Methods

This observational study included participants enrolled as a convenience sample from a larger prospective study of patients with cellulitis receiving IV antibiotics in the emergency department. Point-of-care ultrasound was used to evaluate the PIVCs for thrombus formation after insertion and at specified timepoints after IV administration of antibiotic or saline solution through to discharge. The primary endpoint included the presence and length of the thrombus in proximity of the catheter tip.

Results

Between May 2021 and June 2022, 25 participants were enrolled and received either IV flucloxacillin (n = 10), other IV antibiotics (n = 8) or no IV antibiotics (control; n = 7). PIVC thrombus formation was sonographically detected in 100%, 67% and 17% of patients in flucloxacillin, other and control groups at 6–12 h (flucloxacillin vs. control; P = 0.015), with a mean length of 17.4 ± 8.1 (flucloxacillin vs. control; P = 0.46), 15.5 ± 13.4 (other vs. control; P = 0.73) and 7.3 ± 17.9 mm (control), respectively. Thrombus formation increased significantly in the flucloxacillin group over time (0–>12 h; P = 0.03) but did not increase in the other or control groups.

Discussion

The administration of IV flucloxacillin appears to promote the formation of a PIVC thrombus visible on ultrasound, but the clinical implications are uncertain. Although the vast majority appear to be asymptomatic, they have the potential to become a precursor to thrombophlebitis and lead to early PIVC failure.

Conclusions

It was feasible to identify and measure PIVC thrombus sonographically. Ultrasound showed that IV flucloxacillin administration appeared to be associated with more frequent formation of PIVC thrombus, with these increasing in length over time. Further research is required to confirm these findings in larger studies and to identify any clinical implications of the findings.

目的：本研究旨在通过声像图评估静脉注射氟氯西林是否会增加外周静脉导管（PIVC）血栓形成的风险：这项观察性研究是从一项针对在急诊科接受静脉注射抗生素治疗的蜂窝组织炎患者的大型前瞻性研究中抽取的方便样本。在插入PIVC后，以及在静脉注射抗生素或生理盐水后至出院的特定时间点，采用床旁超声评估PIVC是否有血栓形成。主要终点包括导管尖端附近是否存在血栓以及血栓的长度：2021年5月至2022年6月期间，25名参与者接受了氟氯西林静脉注射（10人）、其他抗生素静脉注射（8人）或无抗生素静脉注射（对照组；7人）。声像图显示，氟氯西林组、其他组和对照组分别有100%、67%和17%的患者在6-12小时内发现PIVC血栓形成（氟氯西林组与对照组相比；P = 0.015），平均长度分别为17.4 ± 8.1（氟氯西林组与对照组相比；P = 0.46）、15.5 ± 13.4（其他组与对照组相比；P = 0.73）和7.3 ± 17.9毫米（对照组）。随着时间的推移，氟氯西林组的血栓形成明显增加（0->12 h；P = 0.03），但其他组和对照组的血栓形成没有增加：讨论：静脉注射氟氯西林似乎能促进超声波可见的PIVC血栓形成，但其临床意义尚不确定。尽管绝大多数血栓似乎没有症状，但它们有可能成为血栓性静脉炎的前兆，并导致 PIVC 早期失效：结论：用超声波识别和测量PIVC血栓是可行的。超声波显示，静脉注射氟氯西林似乎与PIVC血栓的频繁形成有关，而且这些血栓的长度会随着时间的推移而增加。要在更大规模的研究中证实这些发现，并确定这些发现的临床意义，还需要进一步的研究。

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引用次数: 0

Systematic review of musculoskeletal ultrasound learning methodologies 肌肉骨骼超声学习方法的系统综述。

Q3 Medicine

Australasian Journal of Ultrasound in Medicine

Pub Date : 2024-10-21 DOI: 10.1002/ajum.12413

Amber J. Vogt, Robert Samuel Mayer

Introduction/Purpose

As the frequency and morbidity of musculoskeletal (MSK) disorders increase, the use of MSK ultrasound has become an important diagnostic and procedural tool. This has amplified the importance of quality MSK ultrasound training for medical professionals. This systematic review evaluated and compared peer-reviewed journal articles on learning methodologies for MSK ultrasound training.

Methods

Thirty-three articles met inclusion and exclusion criteria and were evaluated.

Results

Results showed a lack of randomised studies that compared learning methodologies.

Conclusion

There was wide variability of methodology used based on educational and institutional needs. Further randomised control trials need to be conducted to ascertain best educational practices.

简介/目的：随着肌肉骨骼（MSK）疾病的频率和发病率的增加，MSK超声的使用已成为重要的诊断和手术工具。这加强了对医疗专业人员进行高质量MSK超声培训的重要性。本系统综述评估和比较同行评议的关于MSK超声训练学习方法的期刊文章。方法：对33篇符合纳入和排除标准的文献进行评价。结果：结果显示缺乏比较学习方法的随机研究。结论：根据教育和机构的需要，使用的方法有很大的可变性。需要进行进一步的随机对照试验来确定最佳的教育实践。

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引用次数: 0