Piedmont Heart Institute, Atlanta, GA 30309, USA.
J Cardiovasc Comput Tomogr. 2011 Jan-Feb;5(1):35-43. doi: 10.1016/j.jcct.2010.09.006. Epub 2010 Oct 1.
Computed tomographic (CT) coronary angiography provides a noninvasive method for coronary plaque detection and quantification, but data are limited on reproducibility of a quantitative evaluation.
Intrarater and interrater reliability of a semiquantitative and highly standardized, fully quantitative approach was evaluated in 480 coronary segments in 30 patients. Quantitative vessel-wall and plaque geometrical parameters (minimal lumen diameter [MLD], minimal lumen area [MLA], percentage of atheroma volume [PAV], and remodeling index [RI]) and compositional parameters (calcified plaque volume [CAP] and % of CAP [%CAP], noncalcified plaque [NCP] and % of NCP [%NCP], high-density NCP volume [HD-NCP] and % of HD-NCP [%HD-NCP] and low-density NCP volume [LD-NCP] and % of LD-NCP [%LD-NCP]) were measured. Semiquantitative agreement was evaluated by weighted κ; quantitative agreement was evaluated by concordance correlation coefficient (CCC) and Bland-Altman analysis.
Intraobserver agreement for MLD, MLA, and RI was excellent (CCC: 0.96, 0.96, and 0.84, respectively). Intraobserver agreement for %CAP, %HD-NCP, and %LD-NCP was also excellent (CCC: 0.99, 0.98,and 0.96, respectively). Interobserver agreement for MLD, MLA, PAV and RI was excellent (CCC: 0.98, 0.99, 0.96,and 0.86, respectively). Interobserver agreement for %CAP, % NCP, %HD-NCP, and %LD-NCP was also excellent (CCC: 0.99, 0.99, 0.98,and 0.90, respectively), and mean differences were small. Quantitative analysis showed statistically significant differences in both geometrical and compositional parameters between normal segments and those with plaque.
Standardized, quantitative analysis of coronary CTA datasets is reproducible for the measurement of plaque geometrical and compositional parameters and can quantify differences between normal and abnormal segments in high-quality datasets.
计算机断层扫描（CT）冠状动脉造影为冠状动脉斑块检测和定量提供了一种非侵入性方法，但关于定量评估的可重复性的数据有限。
在 30 名患者的 480 个冠状动脉节段中评估了半定量和高度标准化的全定量方法的观察者内和观察者间的可靠性。定量血管壁和斑块的几何参数（最小管腔直径[MLD]、最小管腔面积[MLA]、粥样斑块体积百分比[PAV]和重构指数[RI]）和组成参数（钙化斑块体积[CAP]和 CAP 的百分比[%CAP]、非钙化斑块[NCP]和 NCP 的百分比[%NCP]、高密度 NCP 体积[HD-NCP]和 HD-NCP 的百分比[%HD-NCP]和低密度 NCP 体积[LD-NCP]和 LD-NCP 的百分比[%LD-NCP]）。半定量一致性通过加权κ评估；定量一致性通过一致性相关系数（CCC）和 Bland-Altman 分析进行评估。
观察者内 MLD、MLA 和 RI 的一致性非常好（CCC：0.96、0.96 和 0.84）。观察者内 %CAP、%HD-NCP 和 %LD-NCP 的一致性也非常好（CCC：0.99、0.98 和 0.96）。观察者间 MLD、MLA、PAV 和 RI 的一致性非常好（CCC：0.98、0.99、0.96 和 0.86）。观察者间 %CAP、%NCP、%HD-NCP 和 %LD-NCP 的一致性也非常好（CCC：0.99、0.99、0.98 和 0.90），平均差异较小。定量分析显示，正常节段和斑块节段之间的几何和组成参数存在统计学显著差异。
对冠状动脉 CTA 数据集进行标准化、定量分析可以重复测量斑块的几何和组成参数，并可以对高质量数据集的正常和异常节段之间的差异进行量化。
