Automated 3D ultrasound enables novice users to measure arteriovenous fistula maturation parameters with comparable accuracy to conventional duplex by trained sonographers: Results of a benchtop study.
Automated 3D ultrasound enables novice users to measure arteriovenous fistula maturation parameters with comparable accuracy to conventional duplex by trained sonographers: Results of a benchtop study.
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DOI：
10.1177/11297298221074462
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发表时间：
2023-11
影响因子：
1.9
通讯作者：
Ross, John R.
中科院分区：
文献类型：
--
作者：
Calotta, Nicholas A.;Astor, Brad C.;Ross, John R.
动静脉瘘(AVF)被认为是首选的血液透析途径，但在美国创建的所有AVF中，高达50%的AVF永远不成熟。多普勒超声(DUS)可用于预测瘘管成熟度和即将发生的瘘管衰竭。DUS是资源密集型的，与透析患者的依从性差有关，从12%到33%不等。EchoSure是FDA批准的3D多普勒超声设备，可自动提供定量血流和解剖血管信息。该技术可由未经正式超声培训的人员在床边使用，消除了传统双工超声成像的局限性。这项研究将非专业人员手中的EchoSure系统与传统的专家操作的DUS进行了比较，以快速评估台式模型血管系统，并预期在人体动静脉瘘中使用该系统的流量、直径和深度。Duplex和EchoSure都在体积流量超声读数(35%)的预期公差范围内，观测测量与地面真实之间的平均误差(AE)分别为8%和8%。然而，在所有流速测量中，Duplex Pool的平均变异系数(CV)为17%，而EchoSure为4%。关于直径，Duplex测量的AE为15%，所有测量的平均CV为6%，而EchoSure的AE为4%，平均CV为2%。Duplex和EchoSure在所有深度的测量都有相同的AE为2%。两种方法在深度测量方面没有统计学差异(p = 0.05)，但在流速和血管直径(Flow：P = 0.028，ρ = −0.07；直径：P <； 0.001，ρ = 0.69)方面，EchoSure测量得更接近地面真实情况。使用EchoSure的非专业人员获得数据的速度比使用双工超声的专业超声人员快62%(双工141min对EchoSure 87min )。EchoSure可能为临床上的瘘管成像提供一种准确、方便的替代方法。
Arteriovenous fistulae (AVF) are considered the preferred hemodialysis access but up to 50% of all AVF created in the United States never mature. Doppler ultrasound (DUS) is useful for predicting fistula maturity and impending fistula failure. DUS is resource-intensive and is associated with poor compliance rates in dialysis patients, ranging from 12% to 33%. EchoSure is an FDA-cleared 3D Doppler ultrasound device that automatically delivers quantitative blood flow and anatomic vascular information. The technology can be used at the bedside by personnel without formal sonographic training, nullifying limitations of traditional Duplex ultrasound imaging. This study compared the EchoSure system in the hands of inexpert personnel to a traditional expert-operated DUS for rapid assessment of a benchtop model vascular system with flow, diameter, and depth expected in a human AVF. Both Duplex and EchoSure performed within the expected tolerance of ultrasound readings (35%) for volume flow, with the average error (AE) between the observed measurement and the ground truth being 8% for Duplex and 8% for EchoSure. However, the average coefficient of variation (CV) for Duplex pooled over all flow rate measurements was 17% versus 4% for EchoSure. Regarding diameter, Duplex measurements had AE of 15% with an average CV of 6% across all measurements versus EchoSure AE of 4% and average CV of 2%. Duplex and EchoSure measurements over all depths had the same AE of 2%. The two modalities were not statistically different for depth measurement (p = 0.05) but EchoSure measured closer to the ground truth for flow rate and vessel diameter (flow: p = 0.028, ρ = −0.07; diameter: p < 0.001, ρ = 0.69). The inexpert personnel using EchoSure acquired data 62% faster than the expert sonographers using the Duplex ultrasound (141 min for Duplex vs 87 min for EchoSure). EchoSure may offer an accurate and convenient alternative for imaging fistulas in the clinic.
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影响因子：
13.6
作者：
Astor, BC;Eustace, JA;Coresh, J
通讯作者：
Coresh, J
DOI：
10.1053/j.tvir.2016.11.004
发表时间：
2017-03-01
影响因子：
1.7
作者：
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影响因子：
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作者：
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通讯作者：
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DOI：
10.2215/cjn.00730112
发表时间：
2013-05-01
影响因子：
9.8
作者：
Lok, Charmaine E.;Sontrop, Jessica M.;Moist, Louise
通讯作者：
Moist, Louise
影响因子：
1.9
作者：
Ferring, Martin;Henderson, John;Wilmink, Teun
通讯作者：
Wilmink, Teun