外周CT血管造影的多路径曲面重组：诊断准确性和时间效率
Multipath Curved Planar Reformations of Peripheral CT Angiography: Diagnostic Accuracy and Time Efficiency.
作者信息
Schreiner Markus M, Platzgummer Hannes, Unterhumer Sylvia, Weber Michael, Mistelbauer Gabriel, Groeller Eduard, Loewe Christian, Schernthaner Ruediger E
机构信息
Section of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Institute of Computer Graphics and Algorithms, Technical University of Vienna, Favoritenstraße 9-11, 1040, Vienna, Austria.
出版信息
Cardiovasc Intervent Radiol. 2018 May;41(5):718-725. doi: 10.1007/s00270-017-1846-3. Epub 2017 Dec 7.
OBJECTIVES
To compare diagnostic performance and time efficiency between 3D multipath curved planar reformations (mpCPRs) and axial images of CT angiography for the pre-interventional assessment of peripheral arterial disease (PAD), with digital subtraction angiography as the standard of reference.
METHODS
Forty patients (10 females, mean age 72 years), referred to CTA prior to endovascular treatment of PAD, were prospectively included and underwent peripheral CT angiography. A semiautomated toolbox was used to render mpCPRs. Twenty-one arterial segments were defined in each leg; for each segment, the presence of stenosis > 70% was assessed on mpCPRs and axial images by two readers, independently, with digital subtraction angiography as gold standard.
RESULTS
Both readers reached lower sensitivity (Reader 1: 91 vs. 94%, p = 0.08; Reader 2: 89 vs. 93%, p = 0.03) but significantly higher specificity (Reader 1: 94 vs. 89%, p < 0.01; Reader 2: 96 vs. 95%, p = 0.01) with mpCPRs than with axial images. Reader 1 achieved significantly higher accuracy with mpCPRs (93 vs. 91%, p = 0.02), and Reader 2 had similar overall accuracy in both evaluations (94 vs. 94%, p = 0.96). Both readers read mpCPRs significantly faster than axial images (Reader 1: 5'45″ based on mpCPRs vs. 7'40″ based on axial images; Reader 2: 4'41″ based on mpCPRs vs. 6'57″ based on axial images; p < 0.01).
CONCLUSIONS
mpCPRs are a promising 3D reformation technique that facilitates a fast assessment of PAD with high diagnostic accuracy.
目的
以数字减影血管造影为参考标准，比较三维多路径曲面平面重组（mpCPR）与CT血管造影轴位图像在周围动脉疾病（PAD）介入治疗前评估中的诊断性能和时间效率。
方法
前瞻性纳入40例患者（10例女性，平均年龄72岁），这些患者在接受PAD血管内治疗前接受CT血管造影检查，并进行外周CT血管造影。使用半自动工具箱生成mpCPR。每条腿定义21个动脉节段；对于每个节段，由两名阅片者独立在mpCPR和轴位图像上评估是否存在>70%的狭窄，以数字减影血管造影作为金标准。
结果
与轴位图像相比，两名阅片者使用mpCPR时均具有较低的敏感性（阅片者1：91%对94%，p = 0.08；阅片者2：89%对93%，p = 0.03），但特异性显著更高（阅片者1：94%对89%，p < 0.01；阅片者2：96%对95%，p = 0.01）。阅片者1使用mpCPR时的准确性显著更高（93%对91%，p = 0.02），阅片者2在两种评估中的总体准确性相似（94%对94%，p = 0.96）。两名阅片者阅读mpCPR的速度均显著快于轴位图像（阅片者1：基于mpCPR的时间为5分45秒，基于轴位图像的时间为7分40秒；阅片者2：基于mpCPR的时间为4分41秒，基于轴位图像的时间为6分57秒；p < 0.01）。
结论
mpCPR是一种有前景的三维重组技术，有助于快速评估PAD，且诊断准确性高。
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