Abstract
Ultrasound is currently recommended as the first-line examination for abdominal symptoms
in children. However, a pediatric radiologist is not always available on site, especially
during on-call duty. This study was aimed at evaluating the reliability of an innovative
3-D virtual abdominal tele-ultrasonography in this context. A prospective study was
conducted between December 2020 and May 2021 that recruited 103 children undergoing
ultrasound for abdominal pain. Trauma cases were excluded. Four tridimensional acquisitions
were performed with a Smart Sensor 3D device (Canon Medical Systems, Otawara, Japan).
Each tele-ultrasonography was secondarily blindly reviewed by two radiologists (one
senior and one resident) with Fusion software (Canon Medical Systems). Acceptance
and quality of the acquisitions were evaluated on a Likert scale. Inter-rater reliability
was quantified using Cohen's κ coefficient and intraclass correlation coefficient.
The ultrasound examination was normal in 66 cases (64%), abnormal in 36 cases (35%)
and inconclusive in 1 case (1%). The acquisitions were obtained without objections
from the children, their parents or the operators in more than 95% of cases. The quality
of the acquisitions was considered good to excellent in 84% and 70% of cases. The
sensitivity of the senior radiologist and the resident was 86% and 84%, respectively;
specificity was 95% and 92%, positive predictive value 92% and 86% and negative predictive
value 92 and 91% when comparing the conclusions of the standard and the tele-ultrasound
examinations. Cohen's κ coefficients of the diagnosis obtained with the standard and
the tele-ultrasound examinations were 0.82 and 0.71, respectively. The inter-rater
Cohen's κ coefficient was 0.84. The intraclass correlation coefficient between the
standard abdominal examination and the 3-D tele-ultrasound reformatted images for
the following quantitative variables on pathological cases was 0.99 (confidence interval:
0.98–0.99). Virtual abdominal tele-ultrasonography is a promising method in pediatric
emergencies.
Key Words
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Article info
Publication history
Published online: August 30, 2022
Accepted:
July 9,
2022
Received in revised form:
June 1,
2022
Received:
January 10,
2022
Identification
Copyright
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