Department of Diagnostic and Interventional Radiology, University Hospital of Ulm, Steinhövelstr. 9, Ulm, Germany.
Int J Cardiovasc Imaging. 2010 Aug;26(6):711-20. doi: 10.1007/s10554-010-9614-3. Epub 2010 Mar 26.
The purpose of this study was to evaluate the potential clinical value of coronary plaque imaging with a new generation CT scanner and the interobserver variability of coronary plaque assessment with a new semiautomatic plaque analysis application. Thirty-five isolated plaques of the left anterior descending coronary artery from 35 patients were evaluated with a new semiautomatic plaque analysis application. All patients were scanned with a 256-slice MDCT scanner (Brilliance iCT, Philips Healthcare, Cleveland OH, USA). Two independent observers evaluated lesion volume, maximum plaque burden, lesion CT number mean and standard deviation, and relative lesion composition. We found 10 noncalcified, 16 mixed, and 9 calcified lesions in our study cohort. Relative interobserver bias and variability for lesion volume were -37%, -13%, -49%, -44% and 28%, 16%, 37%, and 90% for all, noncalcified, mixed, and calcified lesions, respectively. Absolute interobserver bias and variability for relative lesion composition were 1.2%, 0.5%, 1.5%, 1.3% and 3.3%, 4.5%, 7.0%, and 4.4% for all, noncalcified, mixed, and calcified lesions, respectively. While mixed and calcified lesions demonstrated a high degree of lesion volume interobserver variability, noncalcified lesions had a lower degree of lesion volume interobserver variability. In addition, relative noncalcified lesion composition had a very low interobserver variability. Therefore, there may a role for MDCT in serial noncalcified plaque assessment with semiautomatic analysis software.
本研究旨在评估新一代 CT 扫描仪进行冠状动脉斑块成像的潜在临床价值，以及使用新的半自动斑块分析应用程序评估冠状动脉斑块的观察者间可变性。使用新的半自动斑块分析应用程序评估了 35 名患者的 35 个孤立的左前降支冠状动脉斑块。所有患者均使用 256 层 MDCT 扫描仪（Brilliance iCT，飞利浦医疗，克利夫兰，OH，美国）进行扫描。两位独立观察者评估了病变体积、最大斑块负担、病变 CT 值均值和标准差以及相对病变成分。我们在研究队列中发现了 10 个非钙化、16 个混合和 9 个钙化病变。病变体积的相对观察者间偏倚和变异性分别为 -37%、-13%、-49%、-44%和 28%、16%、37%和 90%，用于所有、非钙化、混合和钙化病变。相对病变成分的绝对观察者间偏倚和变异性分别为 1.2%、0.5%、1.5%、1.3%和 3.3%、4.5%、7.0%和 4.4%，用于所有、非钙化、混合和钙化病变。虽然混合和钙化病变的病变体积观察者间变异性较大，但非钙化病变的病变体积观察者间变异性较低。此外，相对非钙化病变成分的观察者间变异性非常低。因此，MDCT 可能在使用半自动分析软件对非钙化斑块进行连续评估中具有一定作用。
