静脉移植物双功扫描的观察者间一致性
Interobserver agreement in duplex scanning for vein grafts.
作者信息
Ihlberg L, Albäck A, Roth W D, Edgren J, Lepäntalo M
机构信息
Division of Vascular Surgery, Department of Surgery, Helsinki, Finland.
出版信息
Eur J Vasc Endovasc Surg. 2000 May;19(5):504-8. doi: 10.1053/ejvs.1999.1068.
BACKGROUND
although the precision of duplex scanning is of utmost importance in vein-graft surveillance, it has not been properly assessed. This study aims to analyse interobserver agreement on duplex scanning.
METHODS
a blinded comparative trial of 69 infrainguinal vein bypass reconstructions. Two consecutive duplex scans were performed by different examiners and duplex ultrasound machines on the same patient. The duplex examinations were also compared with angiography, when available, and clinical follow-up.
RESULTS
interobserver agreement in Kappa statistics was 0.69, signifying "good" agreement between the examinations in detecting haemodynamically significant changes in the grafts. The sensitivity, specificity and accuracy figures compared with a combination of angiography and follow-up data for the two scans were 80%, 91%, 88% and 85%, 93%, 91%, respectively. The limits of agreement were, however, wide for Doppler-derived velocity characteristics.
CONCLUSION
duplex scanning is an accurate and reproducible method for detecting haemodynamically significant changes in infrainguinal vein grafts.
背景
尽管双功扫描的精确性在静脉移植物监测中至关重要，但尚未得到恰当评估。本研究旨在分析双功扫描的观察者间一致性。
方法
对69例腹股沟下静脉搭桥重建术进行盲法对比试验。由不同检查者使用不同的双功超声机器对同一患者连续进行两次双功扫描。如有血管造影检查，双功检查还与血管造影及临床随访结果进行比较。
结果
Kappa统计量的观察者间一致性为0.69，表明在检测移植物血流动力学显著变化方面，两次检查之间具有“良好”的一致性。与血管造影和两次扫描随访数据组合相比，敏感性、特异性和准确性数值分别为80%、91%、88%和85%、93%、91%。然而，对于多普勒衍生的速度特征，一致性界限较宽。
结论
双功扫描是检测腹股沟下静脉移植物血流动力学显著变化的准确且可重复的方法。
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