Shenouda Ninette, Proudfoot Nicole A, Currie Katharine D, Timmons Brian W, MacDonald Maureen J
Department of Kinesiology, McMaster University, Hamilton, ON, Canada.
Child Health & Exercise Medicine Program, McMaster University, Hamilton, ON, Canada.
Clin Physiol Funct Imaging. 2018 May;38(3):396-401. doi: 10.1111/cpf.12428. Epub 2017 Apr 26.
Many commercial ultrasound systems are now including automated analysis packages for the determination of carotid intima-media thickness (cIMT); however, details regarding their algorithms and methodology are not published. Few studies have compared their accuracy and reliability with previously established automated software, and those that have were in asymptomatic adults. Therefore, this study compared cIMT measures from a fully automated ultrasound edge-tracking software (EchoPAC PC, Version 110.0.2; GE Medical Systems, Horten, Norway) to an established semi-automated reference software (Artery Measurement System (AMS) II, Version 1.141; Gothenburg, Sweden) in 30 healthy preschool children (ages 3-5 years) and 27 adults with coronary artery disease (CAD; ages 48-81 years). For both groups, Bland-Altman plots revealed good agreement with a negligible mean cIMT difference of -0·03 mm. Software differences were statistically, but not clinically, significant for preschool images (P = 0·001) and were not significant for CAD images (P = 0·09). Intra- and interoperator repeatability was high and comparable between software for preschool images (ICC, 0·90-0·96; CV, 1·3-2·5%), but slightly higher with the automated ultrasound than the semi-automated reference software for CAD images (ICC, 0·98-0·99; CV, 1·4-2·0% versus ICC, 0·84-0·89; CV, 5·6-6·8%). These findings suggest that the automated ultrasound software produces valid cIMT values in healthy preschool children and adults with CAD. Automated ultrasound software may be useful for ensuring consistency among multisite research initiatives or large cohort studies involving repeated cIMT measures, particularly in adults with documented CAD.
现在许多商用超声系统都配备了用于测定颈动脉内膜中层厚度（cIMT）的自动分析软件包；然而，关于其算法和方法的详细信息尚未公布。很少有研究将它们的准确性和可靠性与先前已有的自动软件进行比较，而且已有的比较研究对象都是无症状成年人。因此，本研究在30名健康学龄前儿童（3至5岁）和27名患有冠状动脉疾病（CAD；48至81岁）的成年人中，将一款全自动超声边缘跟踪软件（EchoPAC PC，版本110.0.2；GE医疗系统公司，挪威霍滕）测得的cIMT值与一款已有的半自动参考软件（动脉测量系统（AMS）II，版本1.141；瑞典哥德堡）测得的结果进行了比较。对于这两组人群，Bland-Altman图显示二者一致性良好，平均cIMT差异可忽略不计，为 -0·03毫米。对于学龄前儿童图像，软件差异具有统计学意义，但无临床意义（P = 0·001），而对于CAD患者图像则无显著差异（P = 0·09）。在学龄前儿童图像中，软件内部和不同操作人员之间的重复性都很高，且两款软件相当（组内相关系数，ICC，0·90 - 0·96；变异系数，CV，1·3 - 2·5%），但对于CAD患者图像，全自动超声软件的重复性略高于半自动参考软件（ICC，0·98 - 0·99；CV，1·4 - 2·0%，相比之下，半自动参考软件的ICC为0·84 - 0·89；CV，5·6 - 6·8%）。这些结果表明，该全自动超声软件在健康学龄前儿童和患有CAD的成年人中能够得出有效的cIMT值。全自动超声软件可能有助于确保多中心研究项目或涉及重复cIMT测量的大型队列研究结果的一致性，尤其是在有记录的CAD成年患者中。
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