Leong Sook Sam, Vijayananthan Anushya, Yaakup Nur Adura, Shah Nazri, Ng Kwan Hoong, Acharya U Rajendra, Bilgen Mehmet
Department of Biomedical Imaging, University Malaya Medical Centre Kuala Lumpur, Malaysia.
Department of Biomedical Imaging, University Malaya Medical Centre Kuala Lumpur, Malaysia.
Comput Biol Med. 2016 Nov 1;78:58-64. doi: 10.1016/j.compbiomed.2016.09.006. Epub 2016 Sep 12.
To determine the reproducibility of three-dimensional (3D) ultrasound (US) over two-dimensional (2D) US in characterizing atherosclerotic carotid plaques using inter- and intra-observer agreement metrics.
A Total of 51 patients with 105 carotid artery plaques were screened using 3D and 2D US probes attached to the same US scanner. Two independent observers characterized the plaques based on the morphological features namely echotexture, echogenicity and surface characteristics. The scores assigned to each morphological feature were used to determine intra- and inter-observer performance. The level of agreement was measured using Kappa coefficient.
The first observer with 2D US showed fair (k=0.4-0.59) and very strong (k>0.8) with 3D US intra-observer agreements using three morphological features. The second observer indicated moderate strong (k=0.6-0.79) with 2D US and very strong with 3D US (k>0.8) intra-observer performances. Moderate strong (k=0.6-0.79) and very strong (k>0.8) inter-observer agreements were reported with 2D US and 3D US respectively. The results with 2D and 3D US were correlated 62% using only echotexture and 56% using surface morphology coupled with echogenicity. 3D US gave a lower score than 2D 71% of the time (p=0.005) in disagreement cases.
High reproducibility in carotid plaque characterization was obtained using 3D US rather than 2D US. Hence, it can be a preferred imaging modality in routine or follow up plaque screening of patients with carotid artery disease.
使用观察者间和观察者内一致性指标，确定三维（3D）超声（US）在表征动脉粥样硬化性颈动脉斑块方面相对于二维（2D）超声的可重复性。
使用连接到同一超声扫描仪的3D和2D超声探头，对51例患者的105个颈动脉斑块进行筛查。两名独立观察者根据形态学特征（即回声纹理、回声性和表面特征）对斑块进行表征。分配给每个形态学特征的分数用于确定观察者内和观察者间的表现。使用Kappa系数测量一致性水平。
第一位观察者使用2D超声时，使用三种形态学特征的观察者内一致性为中等（k = 0.4 - 0.59），使用3D超声时为非常强（k>0.8）。第二位观察者使用2D超声时表现为中等强度（k = 0.6 - 0.79），使用3D超声时观察者内表现为非常强（k>0.8）。2D超声和3D超声的观察者间一致性分别为中等强度（k = 0.6 - 0.79）和非常强（k>0.8）。仅使用回声纹理时，2D和3D超声的结果相关性为62%，使用表面形态学结合回声性时为56%。在不一致的情况下，3D超声在71%的时间内得分低于2D超声（p = 0.005）。
使用3D超声而非2D超声在颈动脉斑块表征中获得了高可重复性。因此，它可以成为颈动脉疾病患者常规或随访斑块筛查中的首选成像方式。
