Puchner Stefan, Popovic Martin, Wolf Florian, Reiter Markus, Lammer Johannes, Bucek Robert A
Department of Radiology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
J Endovasc Ther. 2009 Jun;16(3):336-42. doi: 10.1583/08-2636.1.
To evaluate the role of 4 different reformation techniques and axial images from multidetector computed tomographic angiography (MDCTA) versus selective carotid arteriography (SCA) in patients with internal carotid artery (ICA) stenosis.
Imaging studies from 50 patients (43 men; mean age 70.3+/-8.0 years, range 51-85) with known cerebrovascular disease who underwent MDCTA and SCA in a single university hospital were retrospectively analyzed. Axial images, multiplanar reformation (MPR), curved planar reformation (CPR), volume rendering threshold (VRT), and virtual angioscopy (VA) images were reviewed by 2 independent observers who were blinded to the results of SCA, which served as the gold standard. The degree of stenosis was categorized as 0%-49%, 50%-69%, or 70%-99%; a stenosis >70% was considered as hemodynamically significant.
Thirty-four hemodynamically significant stenoses were identified on SCA. The agreement with SCA images was good for both observers using axial CT images (kappa = 0.89 for observer 1 and 0.88 for observer 2); corresponding results for MPR and CPR were kappa = 0.91 and 0.92 for observer 1 and 0.88 and 0.91 for observer 2, respectively. VRT (kappa = 0.72 for observer 1 and 0.66 for observer 2) and VA (kappa = 0.74 for observer 1 and 0.70 for observer 2) showed a slightly inferior correlation with SCA images. Sensitivities for reformations and axial CT images were 100% each; corresponding specificities ranged from 85% to 95%.
Axial images as well as all 4 reformation techniques agreed well with SCA in the grading of ICA stenosis.
评估4种不同重建技术及多排螺旋CT血管造影（MDCTA）的轴位图像与选择性颈动脉造影（SCA）相比，在颈内动脉（ICA）狭窄患者中的作用。
回顾性分析在一所大学医院对50例（43例男性；平均年龄70.3±8.0岁，范围51 - 85岁）已知脑血管疾病患者进行MDCTA和SCA检查的影像学研究。由2名对SCA结果不知情的独立观察者对轴位图像、多平面重建（MPR）、曲面重建（CPR）、容积再现阈值（VRT）和虚拟血管镜（VA）图像进行评估，SCA结果作为金标准。狭窄程度分为0% - 49%、50% - 69%或70% - 99%；狭窄>70%被认为具有血流动力学意义。
SCA检查发现34处具有血流动力学意义的狭窄。两名观察者使用轴位CT图像与SCA图像的一致性良好（观察者1的kappa值为0.89，观察者2的kappa值为0.88）；MPR和CPR的相应结果分别为观察者1的kappa值为0.91和0.92，观察者2的kappa值为0.88和0.91。VRT（观察者1的kappa值为0.72，观察者2的kappa值为0.66）和VA（观察者1的kappa值为0.74，观察者2的kappa值为0.70）与SCA图像的相关性稍差。重建图像和轴位CT图像的敏感性均为100%；相应的特异性范围为85%至95%。
轴位图像以及所有4种重建技术在ICA狭窄分级方面与SCA的一致性良好。
