A prospective study of a hand-held ultrasound device in abdominal aortic aneurysm evaluation.
OBJECTIVE
Effective treatment of abdominal aortic aneurysm (AAA) requires both early detection and timely repair to reduce aneurysm-related mortality. The purpose of this prospective study was to evaluate the utility of a hand-held ultrasonography (US) device in AAA screening in a Veterans Affairs vascular surgical service.


METHODS
During a 16-month period, patients with risk factors for AAA were evaluated in a blinded fashion with a hand-held US device performed by physicians. A conventional abdominal duplex US examination was also performed by a certified vascular ultrasonographer. Results of the hand-held US was compared with the conventional duplex US examination.


RESULTS
A total of 104 patients were evaluated (97 men, mean age 67 +/- 6.3 years). The mean times for hand-held and conventional duplex US examinations were 5.3 +/- 3.2 minutes and 3.1 +/- 2.4 minutes (not significant), respectively. Using the conventional duplex US as a reference, the sensitivity and specificity of the hand-held device in detecting a AAA were 93% and 97%, respectively. The positive and negative predictive values of the hand-held device were 89% and 98%, respectively. The likelihood ratios of positive and negative tests of the hand-held US device examination were 82 and 0.14, respectively. The diagnostic accuracy of the hand-held US device as compared with the conventional duplex US was 98%.


CONCLUSIONS
A hand-held portable US device is effective and accurate in AAA screening with results comparable to the conventional abdominal duplex examination. Moreover, hand-held portable US for AAA screening can be performed expeditiously during physical examination. It should be used as an extension in routine physical examination in vascular patients.
Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston VAMC (112), 2002 Holcomb Boulevard, Houston, TX 77030, USA. plin@bcm.tmc.edu
Peter H
PH
Lin
Ruth L
RL
Bush
Sally A
SA
McCoy
Deborah
D
Felkai
Terrance K
TK
Pasnelli
John C
JC
Nelson
Kenneth
K
Watts
Russell C
RC
Lam
Alan B
AB
Lumsden
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D010808:Physical Examination; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013997:Time Factors; D014463:Ultrasonography / Q000295:instrumentation*; D018616:Ultrasonography, Doppler, Duplex