Official Proceedings - AIUM

American Institute of Ultrasound in Medicine Proceedings J Ultrasound Med 32(suppl):S1–S134, 2013will perform ultrasound scans on a group of standardized ultrasound patients.The ultrasound scans will be evaluated using the USAT by 3 ultrasound-credentialedfaculty evaluators from emergency medicine, criticalcare, and radiology, who will be blinded to the identity of the scanners. TheUSAT will then be evaluated for reliability.Results—A specific USAT has been developed for each coreemergency ultrasound application. Ultrasound scans for evaluation arebeing performed.Conclusions—The need for a standardized method to both objectivelyevaluate the quality of an ultrasound image and provide distinctdifferentiation between skill levels of ultrasound users is well documented.The USAT represents one of the first attempts to provide objective assessmentof ultrasound images. We anticipate that the USAT will be avaluable resource to assess the current skills of sonographers and followthe development of these skills over time.1540597 Mid or Late Second-Trimester Doppler Ultrasound of theUterine Artery: Is There a Difference?Koen Deurloo, 1 * John van Vugt, 2 Annemieke Bolte, 3 MartijnHeymans 4 1 Obstetrics and Gynecology, Diakonessenhuis,Utrecht, the Netherlands; 2 Obstetrics and Gynecology,Radboud University Medical Center, Nijmegen, the Netherlands;3 Obstetrics and Gynecology, 4 Clinical Epidemiology andBiostatics, VU University Medical Center, Amsterdam, theNetherlandsObjectives—Uterine artery (UA) Doppler measurements forscreening for hypertensive complications in pregnancy is usually performedat 22 to 24 weeks of gestation. However, most routine targetedultrasound examinations are performed at 19 to 21 weeks of gestation.It would be convenient to include the UA Doppler measurement in theroutine targeted ultrasound; therefore, we studied the correlation of UADoppler measurements at 19 to 21 and 22 to 24 weeks of gestation.Methods—Ninety-seven primigravidas with uncomplicatedsingleton pregnancies were analyzed. Combined UA velocity waveformswere assessed using transabdominal color Doppler ultrasound between 19and 24 weeks of gestation. The resistance index (RI) was calculated forleft and right UAs, and the results were averaged as a combined US RI.After log transformation of the US RI variable, the results were analyzedwith linear regression models and corrected for known confounders (ethnicity,assisted reproductive technology, age, body mass index, and smoking).Unpaired t testing was used to assess the correlation between UA RIsbetween 19 and 21 and 22 and 24 weeks of gestation.Results—Adequate UA velocity waveforms were assessed inall cases. There was no confounding demonstrated for the known confounders.Linear regression analysis showed a significant correlation (r =0.79) between mid and late second-trimester UA Doppler measurements(P < .05).Conclusions—RIs of blood velocity waveforms of the UA at19 to 21 and 22 to 24 weeks of gestation are strongly correlated, and UADoppler measurements might be included in the routine targeted ultrasoundat 19 to 21 weeks of gestation. Further research is needed to assessits screening performance.1540605 Simulation Model as an Adjunct Method for EmergencyMedicine Transvaginal Ultrasound EducationOmar Corujo Vazquez,* Marie Romney, Penelope ChunLema, Cara Brown, Michael Radeos, Eric Tran, Anita DattaEmergency Medicine, New York Hospital Queens, Flushing,New York USAObjectives—This study assessed the importance of a mannequinsimulator model as an addition to a didactic lecture in point-ofcarepelvic ultrasound. We hypothesized an improvement in ultrasoundknowledge, technique, satisfaction, and confidence for residents exposedto the simulation model.S109Methods—First-year residents in emergency medicine wereenrolled in a prospective cohort study to assess an educational intervention.Subjects were randomly divided into a didactic-only group (group A)or didactic combined with simulation group (group B). Both groups receiveddidactic education. Group B received additional hands-on ultrasoundsimulation training with the Combination IUP Ectopic PregnancyTransvaginal Ultrasound Training Model (Blue Phantom, Redmond, WA).Both groups were evaluated by a written test and an objective structuredclinical exam (OSCE) on pelvic ultrasound before and after the intervention.A survey was given to assess resident satisfaction and confidence.Results—Group B increased their pretest to posttest writtenscore by 50% compared to group A (32% vs 21% median increase) but didnot reach statistical significance (P = .074). Group B increased their pretestto posttest OSCE score when compared to group A (31% vs 29.9% median),but this difference was not statistically significant (P = .92). Prior tothe course, 90% of the subjects reported feeling “not at all comfortable”with performing and interpreting normal pelvic ultrasound examinations.After the course, this number decreased to 30% and reached statistical significance(P = .002). When analysis was performed from group B independently,80% of subjects were either “very comfortable” or “extremelycomfortable” performing transvaginal ultrasound after the intervention.Conclusions—Simulation combined with didactic training maybe superior for resident satisfaction and confidence in point-of-care pelvicultrasound teaching. Although there was improvement in knowledge andtechnique, a larger study is needed on the use of simulation training in residenteducation to show significance.1540609 Analysis of Uniformity Artifacts Detected During ClinicalUltrasound Quality ControlScott Stekel,* Nicholas Hangiandreou, Donald TradupRadiology, Mayo Clinic, Rochester, Minnesota USAObjectives—Characterize trends in severity ratings of observedtransducer uniformity artifacts.Methods—We reviewed the results of quarterly quality control(QC) uniformity testing for the previous ≈2 years and characterized theevaluation history of all transducers exhibiting artifacts of any severity.Our evaluation protocol is able to reveal subtle transducer artifacts. All artifactswere scored by a single author (D.T.) using a subjective severityscale. Uniformity artifacts attributed to scanner defects were excludedfrom this analysis.Results—A total of 58 probes with artifacts of varying severity,observed at QC between March 2010 and August 2012, were analyzed.These included probes that exhibited critical artifacts (failed, withscore F), as well as those that did not fail but exhibited at least 2 successivesubcritical artifact scores (P1, P2, or P3).Thirty-one of these 58 probes failed (score F). Twenty-two ofthe 31 failing scores (71%) directly followed a prior QC assessment witha passing score (score P, no artifact seen). Only 9 failures (29%) were directlypreceded by ≥1 subcritical scores. The time between the first subcriticalscore and the failure ranged from 3 to 14 months, with a mean of9.1 months. No reliable trend of progressively worsening subcritical scoresending in failure was seen (the numbers of probe failures with prior improving,stable, and worsening subcritical scores were 2, 7, and 0, respectively).Twenty-seven of the 58 probes with subcritical scores have notfailed. Two of these artifacts spontaneously resolved, returning to scoresof P. The remaining 25 artifacts were observed up to the last recorded QCsession. The time duration of these subcritical artifacts ranged from 0.5 to16.5 months, with a mean of 10.5 months. No reliable trend of progressivelyworsening subcritical scores was seen (the numbers of these probeswith improving, stable, and worsening subcritical scores were 5, 18, and3, respectively).Conclusions—These subjective artifact data are not consistentwith a model of initial minor defects progressively increasing in severityuntil failure occurs. We are working on methods to objectively score artifactseverity, which should allow a more sensitive analysis of artifact behavior.