中国经胸超声心动图检查存图及报告质控现状分析  

Current status of quality control for image archiving and reporting of transthoracic echocardiography in China

作　　者：王益佳[1] 周青[1] 曹省[1] 袁芳洁 周妍 张梅[2] Yijia Wang;Qing Zhou;Sheng Cao;Fangjie Yuan;Yan Zhou;Mei Zhang(Ultrasound Imaging Department,Wuhan University People's Hospital,Wuhan 430060,China;Department of Cardiovascular Medicine,Qilu Hospital,Shandong University,Ji’nan 250012,China)

机构地区：[1]武汉大学人民医院超声影像科,武汉430060 [2]山东大学齐鲁医院心血管内科,济南250012

出　　处：《中华医学超声杂志（电子版）》2024年第7期657-663,共7页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的通过调查经胸超声心动图检查存图标准及报告模板,旨在获取中国各地区各级医疗机构经胸超声心动图存图及报告质量控制的真实现状,为质量控制工作提供指引。方法2023年10月,心脏亚专业超声质量控制工作组在全国范围内开展经胸超声心动图检查存图及报告质量控制问卷调查,分析全国常规经胸超声心动图不同超声模式检查现况。结果调研发现常规经胸超声心动图检查存图率超过80%的二维切面包括心尖四腔心切面(98.97%)、胸骨旁左心室长轴切面(98.65%)、胸骨旁大动脉短轴切面(96.66%)、胸骨旁肺动脉长轴切面(87.96%)、心尖五腔心切面(87.19%)、胸骨旁二尖瓣水平短轴切面(83.63%)。彩色多普勒超声包括心尖四腔心切面二尖瓣前向血流及频谱(94.45%)、心尖四腔心切面三尖瓣反流及反流频谱(92.55%)、心尖五腔心切面主动脉瓣前向血流及频谱(89.50%)、心尖四腔心切面二尖瓣反流及反流频谱(87.77%)、胸骨旁肺动脉长轴切面肺动脉瓣前向血流及频谱(86.26%)、心尖五腔心切面主动脉瓣反流及反流频谱(85.36%)、胸骨旁大动脉短轴切面(85.07%)、胸骨旁左心室长轴切面(83.63%),可基本满足显示心脏腔室结构及各瓣膜血流动力学评估的要求。组织多普勒存图率二尖瓣环间隔壁、二尖瓣环侧壁、三尖瓣环右心室游离壁分别为84.40%、64.75%、25.91%。反映出部分超声医师对左心室舒张功能以及右心室收缩功能的评估未引起足够重视。对经胸超声心动图检查存图及报告最多的建议是缺乏不同心脏疾病的经胸超声心动图存图及报告标准,且需规范化培训。结论大规模调研为心脏质量控制工作的开展提供了重要依据,心脏亚专业超声质量控制组将从硬件设备、人才培训、心脏单病种质控及结构化报告模板等多方面同步开展工作。Objective To obtain the true status of quality control for transthoracic echocardiography image archiving and reports in medical institutions of all levels in various regions of China,in order to provide guidance for quality control work.Methods The"Cardiac Ultrasound Quality Control Working Group"conducted a nationwide survey questionnaire on the quality control of transthoracic echocardiography image archiving and reports.Results The two-dimensional views with an image archiving rate of over 80%in conventional transthoracic echocardiography included apical four chamber view(A4C;98.97%),parasternal long-axis view of the left ventricle(PLAX-LV;98.65%),parasternal short-axis view of the aortic valve(PSAX-AV;96.66%),parasternal long-axis view of the pulmonary artery(PLAX-PA;87.96%),apical five chamber view(A5C;87.19%),and parasternal short-axis view of the mitral valve(PSAX-MV;83.63%).The Doppler sections with an image archiving rate of over 80%included the flow and spectrum of A4C-MV(94.45%),A4C-TR(92.55%),A5C-AV(89.50%),A4C-MR(87.77%),PV(86.26%),A5C-AR(85.36%),PSAX-AV(85.07%),and PLAX-LV(83.63%),which can meet the basic requirements for displaying the structure of heart cavities and evaluating the hemodynamics of each valve.The image archiving rates of tissue Doppler imaging for the septal wall of the mitral annulus,the lateral wall of the mitral annulus,and the right ventricular free wall of the tricuspid annulus were 84.40%,64.75%,and 25.91%,respectively,reflecting that some ultrasound physicians did not pay enough attention to the evaluation of left and right ventricular systolic function.The most common suggestions for image archiving and reporting of transthoracic echocardiography were the lack of standards for image archiving and reporting of transthoracic echocardiography for different cardiovascular diseases,as well as the need for standardized training.Conclusion This large scale research provides an important basis for the implementation of quality control work.The"Cardiac Ultrasound Quality Control Wor

关 键 词：经胸超声心动图检查 结构化报告 单病种 超声 质量控制 

分 类 号：R540.45[医药卫生—心血管疾病]