医院间对运动心肌锝-99m 替曲膦单光子发射计算机断层扫描（SPECT）研究解读的观察者一致性
Interhospital observer agreement in interpretation of exercise myocardial Tc-99m tetrofosmin SPECT studies.
作者信息
Candell-Riera J, Santana-Boado C, Bermejo B, Armadans L, Castell J, Casáns I, Jurado J, Magriñá J, de la Rosa J N
机构信息
Servei de Cardiologia, Hospital General Universitari Vall d'Hebron, P. Vall d'Hebron 119-129, 08035 Barcelona, Spain.
出版信息
J Nucl Cardiol. 2001 Jan-Feb;8(1):49-57. doi: 10.1067/mnc.2001.110388.
BACKGROUND
We sought to determine the degree of interhospital agreement in the interpretation of exercise myocardial technetium-99m tetrofosmin single photon emission computed tomography (SPECT).
METHODS AND RESULTS
Five experienced hospital laboratories were asked to submit 2 sets of myocardial Tc-99m tetrofosmin SPECT images obtained in 150 patients undergoing coronary angiography: group A used a uniform color scale for all hospitals, and group B used the individual color scale in place at each hospital (uniform color scale, nonuniform color scale, and black-and-white scale). Thus a total of 300 images were interpreted by each center without knowledge of any other patient data. Angiographically significant coronary artery disease (< or =50% diameter stenosis) was present in 90 patients (60%). By a majority decision (3 or more centers), the sensitivity was found to be similar for groups A and B (82% and 84%, respectively), but the specificity was significantly higher for group A (87% vs 73%; P =.021). Four or all 5 of the centers agreed on abnormal or normal results of SPECT images in 87% of patients in group A (kappa 0.626) and in 78% of patients in group B (kappa 0.528). The kappa value of 0.617 was obtained for the uniform color scale, 0.467 for the uniform black-and-white scale, and 0.444 for the nonuniform color scale. Agreement on the left anterior descending artery territory (81% for group A and 78% for group B) was similar to that of the right coronary artery territory (79% for A and 75% for B) and to that of the left circumflex artery territory (91% for A and 85% for B). Agreement was similar in patients with 1-, 2-, and 3-vessel coronary artery disease (91%, 88%, and 86% for group A and 81%, 82%, and 82% for group B, respectively).
CONCLUSIONS
In the interpretation of myocardial Tc-99m tetrofosmin SPECT images, good interinstitutional observer agreement was found, mainly when the uniform display method was adopted.
背景
我们试图确定不同医院之间对运动心肌锝-99m 替曲膦单光子发射计算机断层扫描（SPECT）解读的一致程度。
方法与结果
邀请了五家经验丰富的医院实验室提交在 150 例接受冠状动脉造影的患者中获得的两组心肌 Tc-99m 替曲膦 SPECT 图像：A 组对所有医院使用统一的色标，B 组使用各医院现有的单独色标（统一色标、非统一色标和黑白标）。因此，每个中心在不了解任何其他患者数据的情况下解读了总共 300 幅图像。90 例患者（60%）存在血管造影显示的显著冠状动脉疾病（直径狭窄≤50%）。通过多数决定（3 个或更多中心），发现 A 组和 B 组的敏感性相似（分别为 82%和 84%），但 A 组的特异性显著更高（87%对 73%；P = 0.021）。4 个或所有 5 个中心对 A 组 87%的患者（kappa 0.626）和 B 组 78%的患者（kappa 0.528）的 SPECT 图像异常或正常结果达成一致。统一色标的 kappa 值为 0.617，统一黑白标的 kappa 值为 0.467，非统一色标的 kappa 值为 0.444。左前降支区域的一致性（A 组为 81%，B 组为 78%）与右冠状动脉区域的一致性（A 组为 79%，B 组为 75%）以及左旋支区域的一致性（A 组为 91%，B 组为 85%）相似。单支、双支和三支冠状动脉疾病患者的一致性也相似（A 组分别为 91%、88%和 86%，B 组分别为 81%、82%和 82%）。
结论
在心肌 Tc-99m 替曲膦 SPECT 图像解读中，发现机构间观察者一致性良好，主要是在采用统一显示方法时。
Zotero 插件