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Estimation of Spleen Size With Hand‐Carried Ultrasound
Author(s) -
Lee Mitchell,
Roberts J. Mark,
Chen Luke,
Chang Silvia,
Hatala Rose,
Eva Kevin W.,
Meneilly Graydon S.
Publication year - 2014
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/ultra.33.7.1225
Subject(s) - medicine , ultrasound , confidence interval , sonographer , nuclear medicine , radiology , ultrasound imaging , point of care ultrasound , ultrasonography
Objectives Physical examination can identify palpable splenomegaly easily, but evaluating lesser degrees of splenomegaly is problematic. Hand‐carried ultrasound allows rapid bedside assessment of patients. We conducted this study to determine whether hand‐carried ultrasound can reliably assess spleen size. Methods Patients with varying degrees of splenomegaly were studied. Two sonographers blindly measured spleen size in each patient using either a hand‐carried or conventional ultrasound device in random order. Sonographers completed a data sheet indicating the adequacy of the image, clinical measurements of enlargement, and confidence in their observations. Results Sixteen patients (10 male and 6 female; mean age ± SEM, 60 ± 4 years) were recruited. Image quality was adequate or better in all scans with conventional ultrasound and in 15 of 16 scans with hand‐carried ultrasound. The greatest longitudinal measurement recorded was statistically equivalent across ultrasound techniques, with mean values of 16.4 cm (95% confidence interval, 14.8–18.0 cm) for conventional ultrasound and 15.8 cm (95% confidence interval, 14.1–17.4 cm) for hand‐carried ultrasound. The correlation between measurement techniques was r = 0.89 ( P < .0001). Sonographers were somewhat or very confident in the outcomes of all scans with conventional ultrasound and in 15 of 16 cases with hand‐carried ultrasound. In general, it took longer for sonographers to obtain images with hand‐carried ultrasound. Conclusions We have shown that hand‐carried ultrasound can be used at the point of care by trained individuals to diagnose splenomegaly. However, hand‐carried ultrasound images were less likely to be judged excellent, were accompanied by less diagnostic certainty, and took longer to obtain.