Vercellin Alice C Verticchio, Cutolo Carlo A, Dellafiore Carolina, Lava Massimiliano, Tinelli Carmine, De Silvestri Annalisa, Calliada Fabrizio, Milano Giovanni
University Eye Clinic, Foundation IRCCS Policlinico San Matteo, Piazzale Golgi 19, 27100 Pavia, Italy.
University Eye Clinic, DiNOGMI, University of Genoa, Genoa, Italy.
J Ultrasound. 2016 Feb 1;19(2):125-30. doi: 10.1007/s40477-016-0194-5. eCollection 2016.
To evaluate the inter-device reproducibility of retrobulbar blood flow measurements obtained by two commercially available CDI (color Doppler imaging) devices.
The right eyes of 10 healthy volunteers were investigated. Four examiners, namely two ophthalmologists and two radiologists, performed CDI examination of the ophthalmic artery, central retinal artery and temporal short posterior ciliary arteries using both CDI devices: ESAOTE MYLAB™ and SIEMENS ANTARES STELLAR PLUS™. The peak systolic velocity (PSV), the end-diastolic velocity (EDV) and the resulting resistivity index (RI) were averaged for 3 cardiac cycles. To evaluate the reproducibility between both device measurements, the Lin's concordance correlation coefficient (CCC) was used. CCC can be expressed as the product of Pearson's r (the measure of precision) and C_b (the measure of accuracy).
Results show that the inter-device reproducibility for CDI measurements is not acceptable since a poor degree of overall concordance (0.15<CCC<0.37) was obtained: accuracy was high (C_b > 0.71) but overall precision low (0.18< Pearson's r <0.47). Ophthalmologists and radiologists obtained similar results.
To evaluate the causal role of blood flow abnormalities in glaucoma, CDI analysis using different devices seems unreliable. CDI inter-device reproducibility seems unrelated to medical speciality of the examiners. However, to improve present results, the use of similar probes and standardized CDI instrument settings as well as a CDI images analysis by a single grader, might possibly improve the inter-device reproducibility when testing the retrobulbar blood flow velocity.
评估两款市售彩色多普勒成像（CDI）设备进行球后血流测量的设备间再现性。
对10名健康志愿者的右眼进行研究。四名检查者，即两名眼科医生和两名放射科医生，使用两款CDI设备（ESAOTE MYLAB™和西门子ANTARES STELLAR PLUS™）对眼动脉、视网膜中央动脉和颞侧睫状后短动脉进行CDI检查。对3个心动周期的收缩期峰值流速（PSV）、舒张末期流速（EDV）以及由此得出的阻力指数（RI）进行平均。为评估两款设备测量结果之间的再现性，使用了林氏一致性相关系数（CCC）。CCC可表示为皮尔逊相关系数r（精度度量）与Cb（准确度度量）的乘积。
结果显示，CDI测量的设备间再现性不可接受，因为总体一致性较差（0.15 < CCC < 0.37）：准确度较高（Cb > 0.71）但总体精度较低（0.18 < 皮尔逊相关系数r < 0.47）。眼科医生和放射科医生得出了相似的结果。
为评估血流异常在青光眼发病中的因果作用，使用不同设备进行CDI分析似乎不可靠。CDI设备间的再现性似乎与检查者的医学专业无关。然而，为改善当前结果，在测试球后血流速度时，使用相似的探头和标准化的CDI仪器设置，以及由单一评分者进行CDI图像分析，可能会提高设备间的再现性。
