Hillel-Yaffe Medical Center, Hadera, Israel.
J Am Soc Echocardiogr. 2010 Mar;23(3):258-64. doi: 10.1016/j.echo.2009.12.020.
The purpose of this multicenter study was to determine the reliability of visual assessments of segmental wall motion (WM) abnormalities and global left ventricular function among highly experienced echocardiographers using contemporary echocardiographic technology in patients with a variety of cardiac conditions.
The reliability of visual determinations of left ventricular WM and global function was calculated from assessments made by 12 experienced echocardiographers on 105 echocardiograms recorded using contemporary echocardiographic equipment. Ten studies were reread independently to determine intraobserver reliability.
Interobserver reliability for visual differentiation between normal, hypokinetic, and akinetic segments had an intraclass correlation coefficient of 0.70. The intraclass correlation coefficient for dichotomizing segments into normal versus other abnormal was 0.63, for hypokinetic versus other scores was 0.26, and for akinetic versus other scores was 0.58. Similar results were found for intraobserver reliability. Interobserver reliability for WM score index was 0.84 and for left ventricular ejection fraction was 0.78. Similar values were obtained for the intraobserver reliability of WM score index and ejection fraction. Compared to angiographic data, the accuracy of segmental WM assessments was 85%, and correct determination of the culprit artery was achieved in 59% of patients with myocardial infarctions.
Among experienced readers using contemporary echocardiographic equipment, interobserver and intraobserver reliability was reasonable for the visual quantification of normal and akinetic segments but poor for hypokinetic segments. Reliability was good for the visual assessment of global left ventricular function by WM score index and ejection fraction.
本多中心研究的目的是确定在使用现代超声心动图设备的情况下，具有丰富经验的超声心动图医师对各种心脏疾病患者的节段性壁运动（WM）异常和整体左心室功能进行视觉评估的可靠性。
12 名经验丰富的超声心动图医师对 105 份使用现代超声心动图设备记录的超声心动图进行评估，计算视觉评估左心室 WM 和整体功能的可靠性。对 10 份研究进行独立重读，以确定观察者内可靠性。
观察者间视觉区分正常、低运动和无运动节段的可靠性的组内相关系数为 0.70。将节段分为正常与其他异常的二分类，其组内相关系数为 0.63，将节段分为低运动与其他评分的组内相关系数为 0.26，将节段分为无运动与其他评分的组内相关系数为 0.58。观察者内可靠性也得到了类似的结果。WM 评分指数和左心室射血分数的观察者间可靠性分别为 0.84 和 0.78。WM 评分指数和射血分数的观察者内可靠性也得到了类似的值。与血管造影数据相比，节段 WM 评估的准确性为 85%，心肌梗死患者中 59%正确确定了罪犯动脉。
在使用现代超声心动图设备的经验丰富的读者中，视觉定量正常和无运动节段的观察者间和观察者内可靠性是合理的，但低运动节段的可靠性较差。WM 评分指数和射血分数的视觉评估对整体左心室功能的可靠性较好。
