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초음파 경험이 없는 응급의학과 전공의에 의한 현장 고환 초음파의 진단적 정확성에 관한 예비 연구

Preliminary study on diagnosis of acute scrotum using point-of-care ultrasonography by novice emergency residents: a comparison with conventional ultrasonography

대한응급의학회지 2020년 31권 2호 p.221 ~ 227
김기쁨, 김관재, 안창주, 정준영, 정원준, 강창신, 오세광, 조성욱, 민진홍, 조용철, 안홍준, 박정수, 유승, 유연호, 김승환,
소속 상세정보
김기쁨 ( Kim Ki-Pum ) - Chungnam National University Hospital Department of Emergency Medicine
김관재 ( Kim Kwan-Jae ) - Chungnam National University Hospital Department of Emergency Medicine
안창주 ( An Chang-Joo ) - Chungnam National University Hospital Department of Emergency Medicine
정준영 ( Jung Jun-Young ) - Chungnam National University Hospital Department of Emergency Medicine
정원준 ( Jeong Won-Joon ) - Chungnam National University Hospital Department of Emergency Medicine
강창신 ( Kang Chang-Shin ) - Chungnam National University Hospital Department of Emergency Medicine
오세광 ( Oh Se-Kwang ) - Chungnam National University Hospital Department of Emergency Medicine
조성욱 ( Cho Sung-Uk ) - Chungnam National University Hospital Department of Emergency Medicine
민진홍 ( Min Jin-Hong ) - Chungnam National University Hospital Department of Emergency Medicine
조용철 ( Cho Yong-Chul ) - Chungnam National University Hospital Department of Emergency Medicine
안홍준 ( Ahn Hong-Joon ) - Chungnam National University Hospital Department of Emergency Medicine
박정수 ( Park Jung-Soo ) - Chungnam National University Hospital Department of Emergency Medicine
유승 ( Ryu Seung ) - Chungnam National University Hospital Department of Emergency Medicine
유연호 ( Yoo Yeon-Ho ) - Chungnam National University Hospital Department of Emergency Medicine
김승환 ( Kim Seung-Hwan ) - Chungnam National University Hospital Department of Emergency Medicine

Abstract


Objective: The diagnostic accuracy of novice residents in evaluating the scrotal pathology by point-of-care (POC) ultrasonography (US) was compared with that by the conventional US to determine the level of experience required to achieve competency.

Method: Three novice residents underwent a one-day training course on identifying scrotal pathologies using POC US. They performed POC US on patients with an acute scrotum to identify five pathological findings. The diagnosis was confirmed by conventional scrotal US. The sensitivity and specificity of POC US by novice residents were calculated, and the changes in sensitivity and specificity over time were observed.

Results: Sixty-two patients were included; the overall sensitivity and specificity were 76.7% (95% confidence interval [CI], 61.3%-88.2%) and 78.9% (95% CI, 54.4%-93.9%), respectively. Decreased blood flow in the testicle showed very good specificity (100%; 95% CI, 93.8%-100.0%). The sensitivity and accuracy were variable at first 18 scans of each resident, but increased after 18 scans and were maintained over time.

Conclusion: Although the diagnostic accuracy of novice residents in evaluating the scrotal pathology using POC US was variable at first, the accuracy improved over time, especially after 18 scans of each resident. Nevertheless, larger, longterm research is needed to confirm the results of this study.

키워드

Ultrasound; Testicular torsion; Epididymitis; Orchitis; Scrotum

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