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J Korean Soc Emerg Med > Volume 31(2); 2020 > Article
Journal of The Korean Society of Emergency Medicine 2020;31(2): 221-227.
초음파 경험이 없는 응급의학과 전공의에 의한 현장 고환 초음파의 진단적 정확성에 관한 예비 연구
김기쁨 , 김관재 , 안창주 , 정준영 , 정원준 , 강창신 , 오세광 , 조성욱 , 민진홍 , 조용철 , 안홍준 , 박정수 , 유승 , 유연호, 김승환
충남대학교병원 응급의학과
Preliminary study on diagnosis of acute scrotum using point-of-care ultrasonography by novice emergency residents: a comparison with conventional ultrasonography
Kipum Kim , Kwanjae Kim , Changjoo An , Junyoung Jung , Wonjoon Jeong , Changshin Kang , Sekwang Oh , Sunguk Cho , Jinhong Min , Yongchul Cho , Hongjoon Ahn , Jungsoo Park , Seung Ryu , Yeonho Yoo, Seunghwan Kim
Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Korea
Correspondence  Wonjoon Jeong ,Tel: 042-280-6003, Fax: 042-280-6019, Email: gardenjun@hanmail.net,
Received: July 12, 2019; Revised: September 7, 2019   Accepted: September 18, 2019.  Published online: April 30, 2020.
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.
Key words: Ultrasound; Testicular torsion; Epididymitis; Orchitis; Scrotum
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