In Isolation, Is the Parasternal Long Axis (PSLA) View Good Enough?


For a study, researchers sought to evaluate the diagnostic accuracy of a 4-view FOCUS (a focused cardiac ultrasound) examination with the parasternal long-axis (PSLA) view in isolation for diagnosing pericardial effusion. They left ventricular (LV) dysfunction and right ventricular (RV) dilatation. It was a study that looked back at FOCUS photographs. The exams were blinded and randomized for point-of-care ultrasound faculty to review. The primary goal was assessed by contrasting ultrasonography results on a single PSLA image with findings from a full 4-view FOCUS examination, which was the gold standard. The sensitivity and specificity of the experiment were calculated. The results of 100 FOCUS examinations revealed that 36% were normal, 16% had a pericardial effusion, 41% had an LV ejection fraction less than 50%, and 7% had RV dilatation. For pericardial effusion, LV dysfunction, and RV dilatation, the sensitivity and specificity were 81% (CI 0.54–0.95) and 98% (95% CI 0.91–0.99), 100% (95% CI 0.88–1) and 91% (95% CI 0.80–0.97), and 71% (95% CI 0.30–0.94) and 99% (95% CI 0.93–1), respectively. All moderate to large effusions were accurately detected. Only 4 clinically meaningful differences between PSLA alone and the 4-view interpretations were found. The PSLA view was extremely sensitive and specific for detecting LV ejection and moderate to large pericardial effusions when used in isolation. It had high sensitivity but only moderate specificity for detecting RV dilatation.

Source:www.sciencedirect.com/science/article/abs/pii/S0736467922001603



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