Brunot S, Corneloup O, Latrabe V, Montaudon M, Laurent F
Unité d'Imagerie Thoracique et Cardiovasculaire, Groupe Hospitalier Sud Hôpital du Haut-Lévêque, Avenue Magellan, 33604, Pessac, France.
Eur Radiol. 2005 Oct;15(10):2057-63. doi: 10.1007/s00330-005-2844-4. Epub 2005 Jul 14.
The aim of this study was to evaluate the inter-observer and intra-observer agreement of the diagnosis of sub-segmental acute pulmonary embolism (PE) in an inpatient population explored by 16 slice multi-detector spiral computed tomography (MDCT). Four hundred consecutive inpatients were referred for MDCT for the clinical suspicion of acute PE. One hundred and seventy seven (44.2%) had a known cardio-respiratory disease at the time of examination. Inter-observer and intra-observer agreements for the diagnosis of acute PE and of sub-segmental acute PE were assessed blind and independently by three experienced readers and by kappa statistics. Seventy-five patients were diagnosed as having acute PE findings (19.5%), and clots were located exclusively within sub-segmental arteries in nine patients (12%). When clots were limited to sub-segmental or more distal branches of the pulmonary arteries, kappa values were found to be moderate (0.56) to very good (0.85) for the diagnosis of sub-segmental acute PE, whereas for the diagnosis of acute PE in the whole population, kappa values ranged from 0.84 to 0.97. Intra-observer agreement was found to be perfect (kappa=1). MDCT is a reproducible technique for the diagnosis of sub-segmental acute PE as well as for acute PE. In this inpatient population, sub-segmental acute PE was not a rare event.
本研究的目的是评估在通过16层多排螺旋计算机断层扫描（MDCT）检查的住院患者中，亚段急性肺栓塞（PE）诊断的观察者间和观察者内一致性。连续400例因临床怀疑急性PE而接受MDCT检查的住院患者。其中177例（44.2%）在检查时患有已知的心肺疾病。由三位经验丰富的阅片者通过kappa统计独立且盲法评估急性PE和亚段急性PE诊断的观察者间和观察者内一致性。75例患者被诊断为有急性PE表现（19.5%），其中9例（12%）血栓仅位于亚段动脉内。当血栓局限于肺动脉的亚段或更远端分支时，亚段急性PE诊断的kappa值为中等（0.56）至非常好（0.85），而对于整个人群急性PE的诊断，kappa值范围为0.84至0.97。观察者内一致性为完美（kappa = 1）。MDCT是诊断亚段急性PE以及急性PE的可重复技术。在这个住院患者群体中，亚段急性PE并非罕见事件。
