Rotzinger David C, Breault Stéphane, Knebel Jean-François, Beigelman-Aubry Catherine, Jouannic Anne-Marie, Qanadli Salah D
Cardiothoracic and Vascular Division, Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland.
Département D'imagerie Médicale, CIUSSS du Nord-de-l'île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montréal, QC, Canada.
Front Cardiovasc Med. 2019 Apr 10;6:38. doi: 10.3389/fcvm.2019.00038. eCollection 2019.
To assess interobserver variability between a trained radiology technician (RT) and an experienced radiologist in arterial obstruction quantification using the Qanadli obstruction index (QOI), in patients diagnosed with acute pulmonary embolism (APE) at CT pulmonary angiography (CTPA). A RT and a radiologist independently reviewed CTPAs of 97 consecutive, prospectively enrolled patients with APE, and calculated the QOI. They classified patients into three risk categories: high for QOI ≥40%, intermediate for QOI 20-37.5%, low for QOI <20%. Interobserver variability was investigated for QOI as a continuous variable and as a categorical variable (high, intermediate, and low-risk groups). Mean QOI (±SD) was 39.5 ± 24.3% and 38.6 ± 18.9% for the RT and the radiologist, respectively. The mean QOI was not statistically different between the RT and the radiologist ( = 0.502), and the interobserver agreement was excellent (ICC = 0.905). The RT classified 54 patients (55.7%) as high, 17 (17.53%) as intermediate, and 26 (26.8%) as low risk. The radiologist classified 55 patients (56.7%) as high, 22 (22.7%) as intermediate, and 20 (20.6%) as low risk. The interrater agreement for risk stratification was excellent (weighted kappa = 0.844). Once the diagnosis of APE was established, an adequately trained RT achieved an accuracy comparable to that of an experienced radiologist regarding QOI calculation and risk assessment.
为评估在使用卡纳德利阻塞指数（QOI）对急性肺栓塞（APE）患者进行CT肺动脉造影（CTPA）时，训练有素的放射技师（RT）与经验丰富的放射科医生之间的观察者间变异性。一名RT和一名放射科医生独立回顾了97例连续纳入的前瞻性APE患者的CTPA，并计算QOI。他们将患者分为三个风险类别：QOI≥40%为高风险，QOI 20 - 37.5%为中度风险，QOI<20%为低风险。对QOI作为连续变量和分类变量（高、中、低风险组）进行观察者间变异性研究。RT和放射科医生的平均QOI（±标准差）分别为39.5±24.3%和38.6±18.9%。RT和放射科医生之间的平均QOI无统计学差异（P = 0.502），观察者间一致性极佳（ICC = 0.905）。RT将54例患者（55.7%）分类为高风险，17例（17.53%）为中度风险，26例（26.8%）为低风险。放射科医生将55例患者（56.7%）分类为高风险，22例（22.7%）为中度风险，20例（20.6%）为低风险。风险分层的评分者间一致性极佳（加权kappa = 0.844）。一旦确立APE诊断，经过充分训练的RT在QOI计算和风险评估方面达到了与经验丰富的放射科医生相当的准确性。
