Schaefer P J, Pfarr J, Trentmann J, Wulff A M, Langer C, Siggelkow M, Groß J, Knabe H, Schaefer F K W
Diagnostic Radiology, University Hospital Schleswig-Holstein Campus Kiel.
Rofo. 2013 Jul;185(7):628-34. doi: 10.1055/s-0033-1335212. Epub 2013 Jun 5.
To prospectively analyze duplex sonography, CTA, and MRA with respect to stenosis grading of the celiac trunk (TC) and the superior mesenteric artery (SMA), with DSA as the reference.
52 subjects were enrolled (mean age: 71). The image quality was graded: 1-insufficient, 2-bad, 3-moderate, 4-good or 5-excellent. Stenosis was graded: 1 (< 25 %), 2 (25 - < 50 %), 3 (50 - 75 %) or 4 (75 %). Two-sided chi-square tests were used to check for correlation of stenosis grading between modalities. The weighted Cohen's kappa was calculated to assess the strength of correlation. With a threshold of 50 % for non-relevant stenosis vs. relevant stenosis, the sensitivity, specificity, PPV, NPV, and accuracy were calculated.
The mean image quality was 3.8 ± 0.7, 3.1 ± 1.0, 4.4 ± 0.7, and 3.8 ± 0.9 for DSA, duplex sonography, CTA, and MRA, respectively. For both TC and SMA, stenosis grading reached a significant level of correlation between each noninvasive modality with DSA (p < 0.001, each). The weighted Cohen's kappa for duplex sonography/CTA/MRA was 0.94/0.93/0.74, respectively, for the TC and 0.64/0.91/0.56, respectively, for the SMA. Highest sensitivity/specificity/NPV/PPV/accuracy were found for CTA with 100 %/95 %/85 %/100 %/96 % for the TC and with na/98 %/na/100 %/98 %, respectively, for the SMA.
CTA provided the best image quality, reached the highest level of agreement and significance in correlation in stenosis grading, and offered the best diagnostic accuracy.
以前瞻性方式，以数字减影血管造影（DSA）作为参考，分析双功超声、CT血管造影（CTA）和磁共振血管造影（MRA）在腹腔干（TC）和肠系膜上动脉（SMA）狭窄分级方面的情况。
纳入52名受试者（平均年龄：71岁）。对图像质量进行分级：1级-不足，2级-差，3级-中等，4级-良好或5级-优秀。对狭窄程度进行分级：1级（<25%），2级（25%-<50%），3级（50%-75%）或4级（75%）。使用双侧卡方检验来检查不同检查方式之间狭窄分级的相关性。计算加权科恩kappa系数以评估相关性强度。以50%作为非相关狭窄与相关狭窄的阈值，计算敏感性、特异性、阳性预测值、阴性预测值和准确性。
DSA、双功超声、CTA和MRA的平均图像质量分别为3.8±0.7、3.1±1.0、4.4±0.7和3.8±0.9。对于TC和SMA，每种非侵入性检查方式与DSA之间的狭窄分级均达到显著的相关性水平（均p<0.001）。对于TC，双功超声/CTA/MRA的加权科恩kappa系数分别为0.94/0.93/0.74，对于SMA分别为0.64/0.91/0.
