Premium Portable Ultrasound Becomes a Reality at Columbus Children’s Hospital

Premium Portable Ultrasound Becomes a Reality
at Columbus Children’s Hospital
Brian D. Coley, M.D.
Assistant Director, Department of Radiology
Section Chief, Ultrasound
Columbus Children’s Hospital
The last 20 years have seen dramatic progress in the quality of diagnostic ultrasound equipment. The level of
detail and resolution allows for more confident diagnoses and has improved the quality of care in diagnostic
imaging. Over the last 5 to 10 years, hardware and software advances have allowed machines to become
smaller and lighter, providing potential advantages for those performing portable examinations, to scan in
crowded environments such as intensive care units. However, the trade-off for embracing compact ultrasound
has been image quality. While adequate for detection of free fluid or guiding needle access procedures,
compact units have generally been more limited in diagnostic quality. Many radiologists, myself included,
have been uninterested in these compact machines for diagnostic work, especially portable studies on ill
neonates. This is the situation where I need excellent sonographic imaging, and I have been unwilling to
consider lesser units, no matter how convenient and appealing they may appear.
At Columbus Children’s Hospital, we have had the opportunity to utilize ZONARE Medical System’s
ultrasound system, and assess the capabilities of their new P10-4 neonatal neurosonography transducer.
While still a work in progress, my initial response is very enthusiastic from the standard of image quality,
workflow and sonographer productivity, and sonographer stress and comfort.
The goal of any ultrasound examination is to acquire diagnostic quality images. We used the ultrasound
system during portable studies in our neonatal intensive care unit side-by-side with our premium ultrasound
units. As illustrated by the figures, the image quality of the system was felt to rival those produced by
the traditional equipment that have been the mainstays of our department. Abdominal imaging in the NICU
also showed the system to be of equivalent diagnostic quality.
Existing ultrasound system at Columbus Children’s Hospital
Zonare Medical Systems, Inc. – ultrasound system
Normal coronal view of the anterior aspect in a neonatal brain
Existing ultrasound system ultrasound system
Sagittal view of a dilated lateral ventricle with hemorrhage in a neonatal brain
An unanticipated benefit during portable scanning is the ability to move from patient to patient without having
to shut down and restart the ultrasound unit for each patient. Whether using the SuperCart or the portable 5.5
pound scan engine, the system can be moved to the next patient without having to shut down. For our
premium systems, the shutdown and restart process takes about 5 minutes between each patient. While this
doesn’t sound like much, during a typical portable session in the ICU this can easily add 15 to 30 minutes of
additional time that the sonographer is away from the main department, time not spent to scan more carefully,
or to examine additional patients. Additionally, the SuperCart with the scan engine docked is one-third the
weight of conventional premium systems giving our sonographers relief when taking the system
on a portable.
In one case during our trial evaluation, a critically ill neonate needed an examination. The child’s room was
packed with life-support apparatus and concerned family members. It would truly have been difficult to bring
in a conventional ultrasound unit without rearranging both people and equipment. Removing the scan engine
from the SuperCart allowed the sonographer to easily move into the room and efficiently perform the examination (since there was no startup time) with minimal disruption to the medical staff and family.
The ultrasound system that we are using has provided me with the premium imaging performance that
has been lacking in the conventional compact systems we have previously evaluated.
Existing ultrasound system ultrasound system
Transmastoidal view of a neonatal cerebellum
Existing ultrasound system ultrasound system
Sagittal view of a dilated lateral ventricle with hemorrhage in a neonatal brain
Existing ultrasound system ultrasound system
Right sagittal view of liver, gallbladder in a neonatal abdomen with massive ascites
Neonatal abdomen with massive ascites using the ultrasound system’s L10-5 transducer