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.

The "Cardiac Ultrasound Quality Control Working Group" conducted a nationwide survey questionnaire on the quality control of transthoracic echocardiography image archiving and reports.

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.

This large scale research provides an important basis for the implementation of quality control work. The "Cardiac Ultrasound Quality Control Working Group" will carry out work from multiple aspects such as hardware equipment development, clinical training, cardiac single disease ultrasound quality control, and structured report templates simultaneously.

To reveal the dynamic changing trends and characteristics of key ultrasound medical quality control indicators in Sichuan Province from 2020 to 2022.

Based on the Sichuan Provincial Medical Quality Control Data Reporting Platform, we collected and analyzed data on ultrasound quality management control indicators in 21 cities or prefectures in Sichuan Province from 2020 to 2022. The basic situation of ultrasonographers in Sichuan Province as well as the structure, process, and outcome quality analysis indicators was analysed using analysis of variance (ANOVA) or non-parametric tests.

From 2020 to 2022, the average monthly workload of ultrasound physicians and the accuracy rate of ultrasound diagnosis in tertiary specialized hospitals in all cities and prefectures increased year by year, and the doctor-patient ratio in ultrasound departments decreased year by year, with the differences being statistically significant [1.75±0.93 vs 1.59±0.55 vs 1.49±0.56, F=4.11, P=0.020; 770.42±258.30 vs 965.73±323.52 vs 974.75±335.51, F=3.74, P=0.040; (0.79±0.20)% vs (0.95±0.04)% vs (0.96±0.03)%, F=7.39, P<0.001]; in contrast, there was no statistically significant difference in the above indicators in tertiary general hospitals, secondary general hospitals, and secondary specialized hospitals (P>0.05). The completion rate of ultrasound examinations within 48 hours of admission in tertiary general hospitals of all cities and prefectures increased significantly [1.00(0.98, 1.00)% vs 1.00(0.99, 1.00)% vs 1.00(0.97, 1.00)%, H=6.73, P=0.035], but there was no statistically significant difference in tertiary specialized hospitals, secondary general hospitals, and secondary specialized hospitals (P>0.05). When comparing 13 ultrasound quality control indicators in hospitals from 21 cities and prefectures in Sichuan Province in 2020, there were statistically significant differences in four ultrasound quality control indicators: doctor-patient ratio, average monthly workload of ultrasound physicians, positive rate of outpatient and emergency ultrasound reports, and ultrasound diagnostic coincidence rate (P<0.05 for all). In 2021, there were statistically significant differences in three ultrasound quality control indicators: doctor-patient ratio, positive rate of outpatient and emergency ultrasound reports, and ultrasound diagnostic accuracy (P<0.05 for all). However, in 2022, only one ultrasound quality control indicator, ultrasound diagnostic coincidence rate, had a statistically significant difference (P<0.05).

In recent years, the quality control indicators of ultrasound medicine in different cities and prefectures in Sichuan Province have been converging, and the key indicators have been continuously upgraded and improved.

To investigate the the of qualified sections and the rate of cases with qualified sections in prenatal ultrasound screening in Anhui Province, in order to promote the standardization and homogenization of prenatal ultrasound screening and prenatal diagnostic services.

The ultrasound medicine departments of all prenatal screening and/or prenatal diagnosis medical institutions in Anhui Province uploaded the cases screened in March 2023 to the prenatal ultrasound artificial intelligence assistant cloud platform in April 2024 (including at least 2 cases in the first trimester and 5 cases in the second trimester). According to the Practice guidelines for performance of prenatal ultrasound screening (2022) and Chinese expert consensus on assessment standards of obstetric ultrasound training program (2022 edition), intelligent quality control was conducted on the images uploaded by 66 hospitals. The quality control contents included the rate of qualified sections, the rate of cases with qualified sections, single section scores, and sections with lower scores.

A total of 185 cases of prenatal screening in the first trimester were encompassed. The number of cases with non-qualified sections was 91, with an average score of 80.38. The rate of qualified sections and the rate of cases with qualified sections were 40.7% and 50.8%, respectively. The sections obtaining higher scores were the transventricular section (63.8%, 118/185) and the view of nuchal translucency (58.9%, 109/185), while the sections obtaining lower scores were the transverse section of the cord insertion into the fetal abdomen (27.0%, 50/185) and the midsagittal view of the fetus (13.0%, 24/185). The section most often missed was the transverse section of the cord insertion into the fetal abdomen (71.9%, 133/185). A total of 373 cases of prenatal screening in the second trimester were encompassed. The number of cases with non-qualified sections was 265, with an average score of 85.38. The rate of qualified sections and the rate of cases with qualified sections were 54.6% and 29.0%, respectively. The sections obtaining higher scores were the longitudinal cross-section of the tibia and fibula (85.8%, 320/373) and the coronal section of the upper lip (84.2%, 314/373), while the sections obtaining lower scores were the three vessels and trachea view (66.2%, 247/373) and the longitudinal axial section of the humerus (65.4%, 244/373). The section most often missed was the transverse section of the kidneys (16.1%, 60/373).

The low standard rate and integrity rate of ultrasound prenatal screening section in Anhui Province are the common problems faced by hospitals in Anhui province. It is necessary to conduct standardized training for prenatal ultrasound doctors and strengthen quality control before and after the examination.

To analyze the current situation and regional differences of ultrasound medical quality control in Hebei Province by collecting and sorting out the quality control data of hospitals based on a quality control network platform, in order to find the problems and propose solutions.

In 2022, a total of 402 medical institutions with ultrasound medicine specialty in Hebei Province participated in reporting the data to a quality control network platform. The reported data included 12 ultrasound quality control indicators mentioned in the Expert Consensus on the Quality Management and Control Indicators of Ultrasound Medicine ( 2022 Edition): ultrasound physician per capita workload, ultrasonic instrument quality inspection rate, completion rate of ultrasound examination within 48 hours of admission, completion rate of ultrasound critical value report within 10 minutes, qualified rate of ultrasound report writing, classification rate of breast imaging reporting and data system (BI-RADS) for ultrasound report of breast lesions, positive rate of ultrasound report, detection rate of fetal major lethal malformations in ultrasound screening, coincidence rate of ultrasound diagnosis, accuracy of ultrasound diagnosis of breast lesions, coincidence rate of ultrasound diagnosis of carotid stenosis (≥50%), and incidence of major complications related to ultrasound intervention. These data were compared and analyzed.

The average number of daily ultrasound examinations in the whole province was lower than the national average level (23.50 vs 29.99). Among cities in the province, Tangshan had the highest average number of daily ultrasound examinations (30.11 person-times), Handan had the lowest number (17.98 person-times), and 8 cities had a number below the average. The average quality inspection rate of ultrasonic instruments in the whole province was close to the national average level (97.13% vs 97.14%). This rate reached 100% in Cangzhou, Hengshui, and Qinhuangdao, 3 cities had a rate lower than the average, and Tangshan City had the lowest rate at 87.04%. The average completion rate of ultrasound examination within 48 hours of admission in the whole province was slightly higher than the national average level (93.22 % vs 93.07 %). Hengshui had the highest completion rate at 99.93 %, Zhangjiakou had the lowest rate at 79.19%, and three cities had a rate lower than the average. The completion rate of ultrasound critical value report within 10 minutes in the whole province was lower than the national average level (96.87% vs 97.33%). Hengshui and Qinhuangdao had the highest completion rate at 100%, and Cangzhou had the lowest completion rate at 87.63%. The average qualified rate of ultrasound report writing in the whole province was slightly higher than the national average (99.37% vs 99.11%). Qinhuangdao had the highest rate at 99.91%, Chengde had the lowest rate at 95.75%, and 4 cities had a rate below the average. The classification rate of BI-RADS in the ultrasound report of breast lesions in the overall province was lower than the national average level (75.34 % vs 83.95%). Qinhuangdao had the highest classification rate at 98.59%, Shijiazhuang had the lowest rate at 57.03%, and 5 cities had a rate below the average. The positive rate of ultrasound in medical institutions in the province was slightly higher than the national average level (75.37% vs 74.42%). Qinhuangdao had the highest positive rate at 87.83%, Xingtai had the lowest rate at 68.60%, and 6 cities had a rate below the average. The detection rate of fetal major lethal malformations in ultrasound screening in medical institutions in the province was slightly lower than the national average level (0.04% vs 0.06%). Langfang had the highest positive rate at 0.09%, Xingtai had the lowest positive rate at 0.01%, and 5 cities had a rate below the average. The coincidence rate of ultrasound diagnosis in medical institutions in the province was lower than the national average level (86.75 % vs 87.78 %). Chengde had the highest coincidence rate at 94.40%, Handan had the lowest rate at 71.59%, and 4 cities had a rate lower than the average. The accuracy of ultrasound diagnosis of breast masses in medical institutions in the province was higher than the national average level (85.96% vs 82.49%). Chengde had the highest accuracy at 91.98%, Handan had the lowest accuracy at 81.95%, and 5 cities had an accuracy below the average. The accuracy of ultrasound diagnosis of carotid artery stenosis (≥50%) in medical institutions in the province was higher than the national average level (91.84% vs 83.76%). Handan had the highest accuracy at 97.75%, Langfang had the lowest accuracy at 85.39%, and 7 cities had an accuracy below the average. The incidence of major complications related to medical ultrasound intervention in the province was lower than the national average level (0.20% vs 0.41%). Chengde had the highest incidence at 1.15%, Qinhuangdao had the lowest incidence at 0.03%, and 6 cities had an incidence higher than the average.

Based on the data of a quality control network platform, we summarize the current situation and regional differences in ultrasonic medical quality control in Hebei Province, so that we can find problems in time and solve problems to further improve the professional level of ultrasound in the province.

To investigate the current status of quality control indicators and medical service quality in ultrasound medical departments of secondary and tertiary hospitals in Hainan Province, in order to provide reference for the continuous improvement and enhancement of ultrasound diagnostic quality.

The Hainan Ultrasound Medical Quality Control Center collected data on ultrasound diagnostic quality control indicators from 46 secondary and tertiary hospitals in Hainan Province (including 21 secondary hospitals and 25 tertiary hospitals) from January 1, 2024 to December 31, 2023. The indicators investigated included structural quality analysis indicators (monthly average workload of ultrasound physicians, ultrasound instrument quality inspection rate, ultrasound doctor-patient ratio, and ratio of ultrasound physicians to diagnostic instruments), process quality analysis indicators (completion rate of inpatient ultrasound examination within 48 hours, completion rate of ultrasound critical value report within 10 minutes, qualification rate of ultrasound report writing, and classification rate of breast imaging reporting and data system (BI-RADS) for ultrasound report of breast lesions), and result quality analysis indicators (positive rate of outpatient ultrasound reports, positive rate of inpatient ultrasound reports, detection rate of major fatal fetal malformations in ultrasound screening, ultrasound diagnostic compliance rate, and accuracy rate of breast mass ultrasound diagnosis). The rank sum test was used to compare the differences in various indicators between secondary and tertiary hospitals, and P<0.05 was considered statistically significant.

In terms of structural quality analysis indicators, the average monthly workload of ultrasound physicians in tertiary hospitals was significantly higher than that in secondary hospitals [795.75 (551.86, 972.45) person times/month vs 461.63 (347.00, 597.23) person times/month, U=135.00, P=0.005], and the ultrasound doctor-patient ratio in tertiary hospitals was significantly lower than that in secondary hospitals [1.04 (0.86, 1.51) person times/10000 person times vs 1.80 (1.39, 2.40) person times/10000 person times, U=134.50, P=0.005]. There was no statistically significant difference in the quality inspection rate of ultrasound instruments, the number of ultrasound physicians, or the number of diagnostic instruments (P>0.05). Regarding process quality analysis indicators, the reporting rate of ultrasound critical values within 10 minutes [100 (100, 100)% vs 100.00 (100, 100)%, U=22.50, P=0.024] and the BI-RADS classification rate of breast lesions [99.46 (97.30, 100.00)% vs 95.06 (88.88, 99.12)%, U=130.50, P=0.003] were significantly higher in tertiary hospitals than in secondary hospitals. There was no statistically significant difference in the qualified rate of ultrasound report writing or the completion rate of inpatient ultrasound examination within 48 hours (P>0.05). With regard to quality analysis indicators, the positive rate of ultrasound reports in outpatient and emergency departments [76.75 (65.51, 81.96)% vs 64.86 (54.30, 72.21)%, U=153.00, P=0.016], the ultrasound diagnostic accuracy [92.08 (88.84, 94.34)% vs 85.30 (83.20, 90.44)%, U=116.50, P=0.009], the ultrasound diagnostic accuracy for breast masses [86.29 (79.03, 92.07)% vs 79.63 (76.12, 85.20, 90.47)%, U=103.00, P=0.046], and the detection rate of major fatal malformations in ultrasound screening [0.03 (0.00, 0.08)% vs 0.00 (0.00, 0.00)%, U=109.00, P=0.004] were significantly higher in tertiary hospitals than in secondary hospitals. There was no significant difference in the positive rate of in-patient ultrasound reports in secondary and tertiary hospitals (P>0.05).

There are differences in multiple ultrasound quality control indicators between secondary and tertiary hospitals in Hainan Province. Based on the development status of ultrasound departments in secondary and tertiary hospitals in Hainan Province, especially the low compliance rate of ultrasound diagnosis in secondary hospitals compared to tertiary hospitals, the Hainan Ultrasound Medical Quality Control Center will further improve the quality control system, procedures, standards, and plans, and carry out quality control and improvement work in a standardized manner to achieve standardization and homogenization of ultrasound medicine in Hainan Province.

To investigate the basic situation of thyroid ultrasound examination and the use of TIRADS classification in hospitals in Haidian District, and explore the feasibility of promoting the use of the Chinese version of TIRADS (C-TIRADS) to improve the ultrasound diagnosis quality.

An online questionnaire was administered and collected through a WeChat application, and the subjects of the survey were ultrasound departments of hospitals in Haidian District. The questionnaire mainly included three parts: general information of thyroid ultrasound examination, the use of the TIRADS classification, and the report positive rate and diagnostic accordance rate.

A total of 105 questionnaires were collected, of which 91 were valid after removing invalid ones. Seventy (76.9%) hospitals routinely performed thyroid ultrasound examinations, including 12 tertiary and 12 secondary hospitals, as well as 46 primary hospitals. Approximately 12.9% (9/70) of them, mainly tertiary hospitals, performed ultrasound-guided thyroid intervention techniques (including biopsy). Only one secondary hospital conducted these procedures, and none of primary hospitals performed. A total of 35 hospitals (50.0%) used TIRADS classification systems in their ultrasound reports, of which 22 (62.9%) used the C-TIRADS, 11 (31.4%) used the ACR-TIRADS, and 2 (5.7%) used the ATA guidelines. The average report positive rate of thyroid ultrasound was 73.1% and the average diagnostic accordance rate was 85.3%.

Further improvement in the coverage of C-TIRADS usage in hospitals in Haidian District is needed. The Ultrasound Medical Quality Control and Improvement Center of Haidian District will continue to strengthen the quality control of thyroid ultrasonography, promote the use of C-TIRADS in the diagnosis of thyroid nodules, and improve the diagnostic accordance rate.