动脉瘤壁增强的主观和定量评价之间存在差异
Carlos Dier1, Kerby Justin2, Sultan Alhajahjeh2
1From the Department of Neurology (C.D., E.S., A.G., D.M., N.S., C.A., E.A.S.), University of Iowa, Iowa City, Iowa.
对动脉瘤壁增强 (AWE) 的主观评估显示出差的一致性,并且与客观的3D量化不一致. 建议采用客观方法进行准确的AWE评估,特别是对于大或多重的内动脉瘤.
科学领域:
- 神经辐射学神经辐射学
- 医学成像分析 医学成像分析
- 量化MRI是指数量化的MRI.
背景情况:
- 动脉瘤壁增强 (AWE) 通过视觉检查的确定是主观的,容易出错.
- 通过3D方法量化信号强度 (SI),可以客观地确定AWE.
- 这项研究评估了读者之间的协议以及主观和客观AWE评估之间的协议.
研究的目的:
- 评估主观AWE评估的可靠性.
- 将主观AWE评估与一种新的客观3D量化方法进行比较.
- 为了确定人类读者之间以及不同评估技术之间的协议.
主要方法:
- 高分辨率的肌内动脉瘤 (IAs) 的MRI.
- 主观评估由裁决者进行,不同意见由神经放射学家解决.
- 使用内部代码来确定基于规范SI的3D环形AWE (3D-CAWE) 的客观评估.
- 评估者间协议 (κ系数) 和技术间协议 (κ统计) 的分析.
主要成果:
- 内部主观评估显示中等程度的同意 (κ=0.63).
- 内部和外部裁决之间的评价者间协议很弱 (κ=0.52).
- 在主观AWE和客观3D-CAWE (κ=0.16,P=.02) 之间没有发现一致性.
- 对多个IA (OR=0.4) 和IA>7毫米 (OR=0.22) 的主观评估不那么可靠.
结论:
- 主观的AWE评估表现出较差的评价者间一致性,并且与客观的3D量化缺乏一致性.
- 目标3D量化对AWE评估更可靠,特别是在动脉瘤>7毫米或多重动脉瘤的情况下.
- 该研究建议采用客观的3D量化来进行一致和准确的AWE评估.
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