응급의학과 전공의에 의한 장겹침증 초음파 검사는 가능한가?

Abstract

Purpose: The aim of this study was to evaluate the sensitivity and specificity of ultrasonography of suspected ileocolic intussusception performed by emergency medicine (EM)residents who participated in a 2-hour focused ultrasound training program for intussusception. Methods: This was a 16-month retrospective, observational study. Pediatric patients with suspected ileocolic intussusception who underwent ultrasound performed by second or third year EM residents were included in the study. The gold standard was a diagnostic work-up performed by a radiologist or clinical follow-up, compared with the results of ultrasonography performed by EM residents. Results: A total of 38 patients were enrolled. The sensitivity of ultrasound performed by emergency medicine residents for prediction of ileocolic intussusception was 92.86% (66.13% to 99.82%), the specificity was 91.67%(73.00% to 98.97%), the positive likelihood ratio was 11.14(2.93 to 42.34), and the negative likelihood ratio was 0.08(0.01 to 0.52). Conclusion: Emergency residents can identify ileocolic intussusceptions with only minimal training, which could substitute for ultrasonography performed by radiologists when they are not immediately available.