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Image Acquisition Method for the Sonographic Assessment of the Inferior Vena Cava
Published on: January 13, 2023
Sonographic aorta/IVC cross-sectional area index for evaluation of dehydration in children
Hyuksool Kwon1, Jae Yun Jung1, Jin Hee Lee2
1Department of Emergency Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
Insights
A new ultrasound measurement, the aorta/inferior vena cava cross-sectional area index (Ao/IVCA), shows promise for assessing dehydration in children. This index demonstrated a stronger correlation and better predictive ability for dehydration compared to previous methods.
Area of Science:
- Pediatric Emergency Medicine
- Diagnostic Imaging
- Ultrasound Technology
Background:
- Current ultrasound methods lack sufficient evidence for assessing childhood dehydration.
- Effective and reliable diagnostic tools are needed for pediatric dehydration evaluation.
Purpose of the Study:
- To introduce and evaluate a novel sonographic parameter, the aorta/inferior vena cava (IVC) cross-sectional area index (Ao/IVCA), for assessing dehydration in children.
- To compare the diagnostic performance of Ao/IVCA with the aorta/IVC maximal diameter index (Ao/IVCD) and the clinical dehydration scale (CDS).
Main Methods:
- Prospective observational study involving children presenting to a pediatric emergency department.
- Measurement of aorta and IVC dimensions using ultrasound to calculate Ao/IVCA and Ao/IVCD.
- Comparison of sonographic indices with the clinical dehydration scale (CDS).
Main Results:
- A significant correlation was found between Ao/IVCA and CDS (R(2) = 0.30; P <.001).
- Ao/IVCA showed a larger area under the receiver operating characteristic curve (0.87) compared to Ao/IVCD (0.75) for predicting dehydration.
- An Ao/IVCA cut-off value of 1.81 demonstrated 72% sensitivity and 89% specificity.
Conclusions:
- The Ao/IVCA is a promising sonographic index for evaluating dehydration in children.
- Ao/IVCA may offer superior diagnostic performance for dehydration compared to existing ultrasound-based methods.
Objective:
Current studies have not found sufficient evidence to encourage the use of ultrasound for assessing dehydration in children. We introduce a new sonographic parameter, the "aorta/inferior vena cava (IVC) cross-sectional area index" (Ao/IVCA) measured just inferior to the xiphoid process, for the effective evaluation of dehydration in children.
Methods:
This is a prospective, observational study. We enrolled children who presented to the pediatric emergency department (PED) between May 2014 and January 2015. We measured the maximum diameter of the aorta from inner wall to inner wall, and the long and short axis diameters of IVC using a convex array transducer. Ao/IVCA was calculated and compared with aorta/IVC maximal diameter index (Ao/IVCD) and the clinical dehydration scale (CDS).
Results:
A total of 34 children were enrolled. We found a statistically significant correlation between Ao/IVCA and CDS (R(2) = 0.30; P <.001). Ao/IVCD did not correlate significantly with CDS (R(2) = 0.08; P =.11). The ability of Ao/IVCA and Ao/IVCD to predict CDS ≥1 was assessed using the receiver operating characteristic analysis. The area under the receiver operating characteristic curve for Ao/IVCA was larger than that for Ao/IVCD (0.87 vs 0.75, P= .04). The cut-off value of Ao/IVCA that yielded the maximum value of Youden index was 1.81 (sensitivity: 72%, specificity: 89%).
Conclusions:
Ao/IVCA might be a promising index for the assessment of dehydration. The diagnostic performance of Ao/IVCA for dehydration might be higher than that of the method that uses the maximum diameter of IVC and the aorta.
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