White Philip M, Wardlaw Joanna M, Lindsay Kenneth W, Sloss Stuart, Patel Dilip K B, Teasdale Evelyn M
University Department of Neurosurgery, Institute of Neurological Sciences, Southern General Hospital, Glasgow G52 4TF, UK.
Eur Radiol. 2003 Feb;13(2):389-96. doi: 10.1007/s00330-002-1520-1. Epub 2002 Jun 28.
Can non-neuroradiologists detect intracranial aneurysms as well as neuroradiologists, using CT and MR angiography? Sixty patients undergoing intra-arterial digital subtraction angiography (IADSA) to detect aneurysms also underwent computed tomographic angiography (CTA) and time-of-flight magnetic resonance angiography (MRA). Consensus review of IADSA by two neuroradiologists was the reference standard. Two neuroradiologists, a neurosurgeon, a neuroradiographer and a general radiologist blinded to IADSA, plain CT and clinical data, independently reviewed hard-copy base and reconstructed maximum intensity projection images of the CTA and MRA studies. Thirty patients had a total of 63 aneurysms, 71.4% were </=5 mm in size. Compared with IADSA, mean accuracy per patient for neuroradiologists was CTA 0.87 (95% CI 0.75-0.94), and MRA 0.82 (0.70-0.90); for the other observers it was CTA 0.81 (0.75-0.86), and MRA 0.78 (0.71-0.84). Sensitivity per aneurysm for neuroradiologists was CTA 0.63 (0.50-0.75), and MRA 0.43 (0.6-0.74); for the other observers it was CTA 0.52 (0.44-0.59), and MRA 0.38 (0.31-0.45). Differences between readers and modalities were not statistically significant. Agreement with IADSA was "good" for neuroradiologists: kappa 0.73 for CTA, and 0.63 for MRA. For the other observers, agreement with IADSA was "moderate": kappa 0.59 for CTA, and 0.56 for MRA. Neuroradiologists performed consistently better than the other observers, although differences did not reach statistical significance.
非神经放射科医生使用CT血管造影（CTA）和磁共振血管造影（MRA）检测颅内动脉瘤的能力能与神经放射科医生相媲美吗？60例接受动脉数字减影血管造影（IADSA）以检测动脉瘤的患者同时接受了计算机断层血管造影（CTA）和时间飞跃磁共振血管造影（MRA）检查。两位神经放射科医生对IADSA的一致性评估为参考标准。两位神经放射科医生、一位神经外科医生、一位神经放射技师和一位对IADSA、平扫CT及临床数据不知情的普通放射科医生，独立审阅了CTA和MRA检查的硬拷贝图像及重建的最大密度投影图像。30例患者共有63个动脉瘤，其中71.4%的动脉瘤大小≤5mm。与IADSA相比，神经放射科医生对每位患者的平均准确率为CTA 0.87（95%可信区间0.75 - 0.94），MRA 0.82（0.70 - 0.90）；其他观察者的平均准确率为CTA 0.81（0.75 - 0.86），MRA 0.78（0.71 - 0.84）。神经放射科医生对每个动脉瘤的敏感度为CTA 0.63（0.50 - 0.75），MRA 0.43（0.6 - 0.74）；其他观察者的敏感度为CTA 0.52（0.44 - 0.59），MRA 0.38（0.31 - 0.45）。阅片者之间以及不同检查方式之间的差异无统计学意义。神经放射科医生与IADSA的一致性为“良好”：CTA的kappa值为0.73，MRA为0.63。对于其他观察者，与IADSA的一致性为“中等”：CTA的kappa值为0.59，MRA为0.56。尽管差异未达到统计学意义，但神经放射科医生的表现始终优于其他观察者。
