量化主观:长度与高度的比特征是阿卡拉西亚食道扭曲性
John O Barron1, Soon Moon2, Sadia Tasnim1
1Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland, USA.
Surgical endoscopy
|August 10, 2023
概括
这项研究引入了一个客观的长度与高度比 (LHR) 来分类食道形态在阿喀拉西亚,克服主观的解释变化,并使未来的结果研究.
科学领域:
- 胃肠病学 胃肠病学
- 医疗成像医学成像
- 定量分析 定量分析
背景情况:
- 在阿喀拉西亚的食道形态影响患者的结果,与sigmoidal形状往往表明更糟糕的预后.
- 使用定时食道图 (TBE) 对食道形态的客观表征是有限的.
- 主观TBE解释的变化阻碍了对形态学在阿喀拉西亚中的作用的准确评估.
研究的目的:
- 描述从TBE解释食道形态的变异性.
- 通过使用长度与高度比 (LHR) 来评估TBE扭曲性的客观分类方法.
- 测试西格形态与增加的LHR相关的假设.
主要方法:
- 分析了90个手术前的TBE,将形态分类为直线,中间或西格形.
- 从TBE测量了食道长度和垂直高度,以计算LHR.
- 评估了观察者之间的一致性,并比较了各个形态的中位数LHR.
- 利用ROC分析来确定Sigmoidal形态的最佳LHR切线.
主要成果:
- 专家在62.2%的病例中就形态学达成共识,观察者之间的共识在62%-74%之间.
- 中位数LHR与形态严重程度显著增加:1.03 (直线),1.09 (中间) 和1.24 (半体) (p < 0.001).
- 1.13的LHR切线显示出100%的灵敏度和95%的特异性来识别西格形态 (AUC 0.99).
结论:
- 从TBE中对食道形态的主观解释显示了观察者之间的显著变化.
- 在LHR提供了一个客观的,可靠的方法来分类食道曲性在阿喀拉西亚.
- 这种客观的LHR分类克服了以前的局限性,促进了对形态学对阿喀拉西亚结果影响的未来研究.
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