Personal ultrasound imager: abdominal aortic aneurysm screening

Miniaturized ultrasonographic machines (2.5-MHz curved-array transducer connected to a compact 2.6-kg console), termed personal ultrasound imagers (PUIs), may enable detection of occult abdominal aortic aneurysms (AAAs).

Our goals were to determine whether a PUI is capable of screening for AAAs and to compare the results with an established screening examination with standard echocardiography (SE).

One hundred twenty-five patients (aged >70 years) with hypertension who were referred for transthoracic echocardiography were enrolled. After SE, a focused screening with a PUI examination was performed by a blinded sonographer. An AAA was defined as a focal enlargement of the aorta >30 mm. Results and the length of time to image the aorta were compared for both tests.

We studied 64 men and 61 women (aged 76.8 +/- 5 years; mean blood pressures: systolic 145.7 +/- 18 and diastolic 78.6 +/- 10; body surface area 1.9 +/- 0.2 m(2)). The mean time for SE was 2.9 +/- 1.5 minutes and for the PUI examination was 4.6 +/- 2.3 minutes. By using SE as the gold standard, the sensitivity and specificity of the PUI were 91% and 96%, respectively. The positive predictive value of the PUI was 71%, and the negative predictive value was 99%.

A PUI can be used to screen for occult AAAs as an extension of the physical examination. Results are comparable to an established screening strategy that uses more expensive, nonportable echocardiographic equipment.