TY - JOUR
T1 - A paired comparison of nerve dimensions using B-Mode ultrasound and shear wave elastography during regional anaesthesia
AU - Lockwood, Heather
AU - McLeod, Graeme A.
N1 - Funding Information:
We acknowledge the University of Dundee Medical School for funding Heather Lockwood during her 8-week Summer Scholarship in order that this study be carried out. We thank Katrin Skerl, PhD Student, School of Medicine, University of Dundee for her technical help and Supersonic Imagine, Aix-en-Provence for loan of an Aixplorer ultrasound machine.
Copyright:
© The Author(s) 2022.
PY - 2022/11
Y1 - 2022/11
N2 - Introduction: Shear wave elastography (SWE) presents nerves in colour, but the dimensions of its colour maps have not been validated with paired B-Mode nerve images. Our primary objective was to define the bias and limits of agreement of SWE with B-Mode nerve diameter. Our secondary objectives were to compare nerve area and shape, and provide a clinical standard for future application of new colour imaging technologies such as artificial intelligence. Materials and Methods: Eleven combined ultrasound-guided regional nerve blocks were conducted using a dual-mode transducer. Two raters outlined nerve margins on 110 paired B-Mode and SWE images every second for 20 s before and during injection. Bias and limits of agreement were plotted on Bland-Altman plots. We hypothesized that the bias of nerve diameter would be <2.5% and that the percent limits of agreement would lie ±0.67% (2 SD) of the bias.Results: There was no difference in the bias (95% confidence interval (CI) limits of agreement) of nerve diameter measurement, 0.01 (−0.14 to 0.16) cm, P = 0.85, equivalent to a 1.4% (−56.6% to 59.5) % difference. The bias and limits of agreement were 0.03 (−0.08 to 0.15) cm 2, P = 0.54 for cross-sectional nerve area; and 0.02 (−0.03 to 0.07), P = 0.45 for shape. Reliability (ICC) between raters was 0.96 (0.94–0.98) for B-Mode nerve area and 0.91 (0.83–0.95) for SWE nerve area. Conclusions: Nerve diameter measurement from B-Mode and SWE images fell within a priori measures of bias and limits of agreement.
AB - Introduction: Shear wave elastography (SWE) presents nerves in colour, but the dimensions of its colour maps have not been validated with paired B-Mode nerve images. Our primary objective was to define the bias and limits of agreement of SWE with B-Mode nerve diameter. Our secondary objectives were to compare nerve area and shape, and provide a clinical standard for future application of new colour imaging technologies such as artificial intelligence. Materials and Methods: Eleven combined ultrasound-guided regional nerve blocks were conducted using a dual-mode transducer. Two raters outlined nerve margins on 110 paired B-Mode and SWE images every second for 20 s before and during injection. Bias and limits of agreement were plotted on Bland-Altman plots. We hypothesized that the bias of nerve diameter would be <2.5% and that the percent limits of agreement would lie ±0.67% (2 SD) of the bias.Results: There was no difference in the bias (95% confidence interval (CI) limits of agreement) of nerve diameter measurement, 0.01 (−0.14 to 0.16) cm, P = 0.85, equivalent to a 1.4% (−56.6% to 59.5) % difference. The bias and limits of agreement were 0.03 (−0.08 to 0.15) cm 2, P = 0.54 for cross-sectional nerve area; and 0.02 (−0.03 to 0.07), P = 0.45 for shape. Reliability (ICC) between raters was 0.96 (0.94–0.98) for B-Mode nerve area and 0.91 (0.83–0.95) for SWE nerve area. Conclusions: Nerve diameter measurement from B-Mode and SWE images fell within a priori measures of bias and limits of agreement.
KW - Clinical–physics and engineering
KW - anaesthesia
KW - artificial intelligence
KW - quality assurance–physics and engineering
KW - statistics
UR - http://www.scopus.com/inward/record.url?scp=85130217271&partnerID=8YFLogxK
U2 - 10.1177/1742271X221091726
DO - 10.1177/1742271X221091726
M3 - Article
C2 - 36969534
SN - 1742-271X
VL - 30
SP - 346
EP - 354
JO - Ultrasound
JF - Ultrasound
IS - 4
ER -