Græbe Martin, Entrekin Robert, Collet-Billon Antoine, Harrison Gerard, Sillesen Henrik
Department of Vascular Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Philips Healthcare, Bothell, Washington, USA.
Ultrasound Med Biol. 2014 Jul;40(7):1641-9. doi: 10.1016/j.ultrasmedbio.2014.01.019. Epub 2014 Apr 13.
Compared with single 2-D images, emerging 3-D ultrasound technologies hold the promise of reducing variability and increasing sensitivity in the quantification of carotid plaques for individual cardiovascular risk stratification. Inter- and intra-observer agreement between a manual, cross-sectional, 2-D freehand sweep and a mechanical 3-D ultrasound investigation of 62 carotid artery plaques is reported with intra-class correlation coefficients (with 95% confidence intervals). Inter-observer agreement was 0.60 (0.29-0.77) for the freehand method and 0.89 (0.83-0.93) for the mechanical 3-D acquisition. The use of semi-automated computerized planimetric measurements of plaque burden has high intra-observer repeatability, but is vulnerable to systematic inter-observer differences. For the 2-D freehand sweep, a considerable contribution to variation is introduced by the scanning procedure itself, that is, the lack of controlled motion along the third dimension. Future implementation of 3-D ultrasound quantification in large-scale studies of inter-individual cardiovascular risk assessment seems justified using the methods described.
与单一的二维图像相比，新兴的三维超声技术有望在个体心血管风险分层的颈动脉斑块量化中减少变异性并提高敏感性。报告了62个颈动脉斑块的手动横断面二维徒手扫查与机械三维超声检查之间的观察者间和观察者内一致性，并给出了组内相关系数（及其95%置信区间）。徒手扫查法的观察者间一致性为0.60（0.29 - 0.77），机械三维采集法的观察者间一致性为0.89（0.83 - 0.93）。使用半自动计算机化的斑块负荷平面测量法具有较高的观察者内重复性，但易受观察者间系统差异的影响。对于二维徒手扫查，扫描过程本身，即缺乏沿第三维度的受控运动，会对变异性产生相当大的影响。使用所述方法，三维超声量化在个体间心血管风险评估的大规模研究中的未来应用似乎是合理的。
