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Handheld ultrasound for portal vein evaluation in pediatric patients
Ulrich Kaiser1, Fabian Kück2, Christian Stroszczynski3
1Medical Clinic and Polyclinic III, University Hospital Regensburg, Regensburg, Germany.
Insights
A handheld ultrasound device (HUD) offers sufficient image quality for pediatric portal vein (PV) assessment, though its performance decreases with deeper structures. Diagnostic capabilities are lower compared to high-end systems, particularly with increased object depth.
Area of Science:
- Medical Imaging
- Pediatric Radiology
- Ultrasound Technology
Background:
- Portal vein (PV) evaluation is crucial in pediatric diagnostics.
- Handheld ultrasound devices (HUDs) offer portability but require validation for specific applications.
- Assessing diagnostic capabilities of modern HUDs is essential for clinical utility.
Purpose of the Study:
- To evaluate the diagnostic performance of a modern HUD for pediatric PV assessment.
- To determine if patient age, body mass index (BMI), and object depth affect HUD image quality.
- To compare HUD performance against a cart-based high-end ultrasound system (HEUS).
Main Methods:
- 45 pediatric patients (3.9 months–17.9 years) were scanned using both HUD and HEUS.
- B-Mode and Color-coded Doppler sonography (CCDS) were employed for PV imaging.
- Image quality was rated on a 5-point Likert scale and correlated with patient factors and object depth (skin-to-portal-vein-distance, SPVD).
Main Results:
- The HUD achieved image quality scores of ≥4 points (mild/no limitations) in 60% (B-Mode) and 56% (CCDS) of cases.
- A significant negative correlation was found between HUD image quality and SPVD for both B-Mode and CCDS.
- The influence of BMI and SPVD on image quality differed significantly between HUD and HEUS.
Conclusions:
- HUDs provide sufficient to excellent image quality for pediatric PV assessment, except for deep-seated vessels.
- The diagnostic performance of HUDs is lower than HEUS, primarily due to limitations with increased object depth.
- Object depth is a key factor influencing HUD image quality in pediatric portal vein evaluations.
Objective:
To assess diagnostic capabilities of a modern handheld ultrasound device (HUD) for portal vein (PV) evaluation in pediatric patients and to verify if age, body mass index (BMI) and object depth correlate to imagequality.
Methods:
45 patients (3.9 months- 17.9 years; 10.3 years±5.4) were examined using a HUD and cart-based high-end ultrasound system (HEUS). The intra-and extrahepatic PV was scanned using B-Mode and Color-coded Doppler sonography (CCDS). A five-point Likert scale was applied to evaluate image quality. Results were interpreted by two readers in consensus. Scores were compared between the scanners and correlated to age, BMI and skin-to-portal-vein-distance (SPVD). The influence on image quality and the difference between the two devices were analyzed using ordinal and Bayesian logistic regression models.
Results:
≥4 points (mild or no limitations) were achieved by the HUD in 60% for B-Mode and 56% for CCDS. There was a statistically significant negative correlation between the image quality achieved by the HUD and the SPVD for B-Mode and CCDS. The effect of BMI and SPVD on having≥4 points differed significantly between the HUD and HEUS for B-Mode and for CCDS.
Conclusions:
Sufficient to excellent image quality for portal vein assessment in pediatric patients was achieved by the HUD except for the most deep-lying structures. Compared to HEUS, diagnostic performance of the HUD is lower, based on a negative correlation with object depth.
