Use of high frequency ultrasound to detect changes in skin integrity: An image evaluation validation procedure
Use of high frequency ultrasound to detect changes in skin integrity: An image evaluation validation procedure
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DOI：
10.1016/j.iccn.2014.08.002
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发表时间：
2015-06-01
影响因子：
5.3
通讯作者：
Schubert, Christine M.
中科院分区：
文献类型：
--
作者：
Grap, Mary Jo;Burk, Ruth Srednicki;Schubert, Christine M.
目的：高频超声（HFUS）扫描可用于预防、检测和监测高危患者的压疮，并适合各种临床医生便携式床边使用。关于确定代表组织损伤的理想图像或组织变化测量标准的数据有限。我们制定并评价了整体图像质量和组织完整性测量标准。方法：在3个ICU的40名机械通气成人中，使用整体图像质量和组织变化标准评价了241张HFUS骶骨图像的一致性（真皮、皮下层厚度和层密度）。在三项分析中评价了HFUS骶骨图像（N=241），使用总体质量的特定标准，所有三项分析均显示一致性较差，但当标准失效时，一致性良好至实质性。评价协议层厚度和层密度也是好的。结论：一个全球评级是足够的识别良好的图像。层厚度和密度测量的一致性也很好，可能有助于识别导致组织损伤的组织完整性的早期变化。还需要更多的数据来说明层厚度和层密度的变化与最终组织损伤之间的关系。(c)2014爱思唯尔有限公司版权所有。
Objectives: High frequency ultrasound (HFUS) scanning may be used for prevention, detection and monitoring of pressure ulcers in patients at risk and is amenable for portable, bedside use by a variety of clinicians. Limited data are available about the criteria to determine an ideal image or measures of tissue changes representative of tissue injury. We developed and evaluated criteria for overall image quality and measures of tissue integrity.Methods: In 40 mechanically ventilated adults in 3 ICUs, 241 HFUS sacral images were evaluated for agreement using criteria for overall image quality and tissue changes (dermal, hypodermal layer thickness and layer density).Results: HFUS sacral images (N=241) were evaluated in three analyses and showed poor agreement in all three analyses using the specific criteria for global quality, however when criteria were collapsed agreement was good to substantial. Evaluator agreement for layer thickness and layer density was also good.Conclusions: A global rating is adequate for identifying good images. Agreement for measurements of layer thickness and density were also good and may be useful to identify early changes in tissue integrity leading to tissue injury. Additional data are needed concerning the association of changes in layer thickness and layer density to eventual tissue injury. (c) 2014 Elsevier Ltd. All rights reserved.