Lovett J K, Gallagher P J, Rothwell P M
Stroke Prevention Research Unit, University Department of Clinical Neurology, Radcliffe Infirmary, Oxford OX2 6HE, UK.
Cerebrovasc Dis. 2004;18(2):117-23. doi: 10.1159/000079259. Epub 2004 Jun 22.
Thromboembolism from carotid plaque is an important cause of stroke. Identification of unstable plaque would therefore be clinically useful. Unfortunately, studies of carotid plaque imaging have shown poor agreement with histology. However, this may be due to inconsistent methods and the variability of assessments of carotid plaque histology, rather than inadequate imaging.
We assessed the reproducibility of histological assessment in 60 plaques, and section-to-section variability along the length of 26 plaques.
Kappa values ranged from 0.35 to 0.89 and from 0.44 to 0.68, respectively, for intra- and inter-observer reproducibility. There was considerable section-to-section variability within plaques.
The accuracy of imaging of carotid plaque morphology will be underestimated unless variability in the histology assessment is taken into account.
颈动脉斑块导致的血栓栓塞是中风的一个重要原因。因此，识别不稳定斑块具有临床意义。遗憾的是，颈动脉斑块成像研究显示其与组织学结果的一致性较差。然而，这可能是由于方法不一致以及颈动脉斑块组织学评估的变异性，而非成像不足所致。
我们评估了60个斑块组织学评估的可重复性，以及26个斑块沿长度方向的节段间变异性。
观察者内和观察者间可重复性的kappa值分别为0.35至0.89和0.44至0.68。斑块内存在相当大的节段间变异性。
除非考虑到组织学评估中的变异性，否则颈动脉斑块形态成像的准确性将被低估。
