Chan Chun Wai, Chow Sze Chai Christy, Kwok Man Hei, Ngan Ka Ching Tiffany, Or Tsun Hei, Gunda Simon Takadiyi, Ying Michael
Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong SAR, China.
Ultrasonography. 2023 Apr;42(2):214-226. doi: 10.14366/usg.22123. Epub 2022 Oct 27.
Carotid vessel wall volume (VWV) measurement on three-dimensional ultrasonography (3DUS) outperforms conventional two-dimensional ultrasonography for carotid atherosclerosis evaluation. Although time-saving semi-automated algorithms have been introduced, their clinical availability remains limited due to a lack of validation, particularly an extensive reliability analysis. This study compared inter-observer and intra-observer reliability between manual segmentation and semi-automated segmentation for carotid VWV measurements on 3DUS.
Thirty-one 3DUS volume datasets were prospectively acquired from 20 healthy subjects, aged >18 years, without previous stroke, transient ischemic attack, or cardiovascular disease. Five observers segmented all volume datasets both manually and semi-automatically. The process was repeated five times. Reliability was expressed by the intraclass correlation coefficient, supplemented by the coefficient of variation.
Carotid VWV measurements using the common carotid artery (CCA) were more reliable than those using the internal carotid artery (ICA) or external carotid artery (ECA) for both manual and semiautomated segmentation (manual segmentation, CCA: inter-observer, 0.935; intra-observer, 0.934 to 0.966; ICA: inter-observer, 0.784; intra-observer, 0.756 to 0.878; ECA: inter-observer, 0.732; intraobserver, 0.919 to 0.962; semi-automated segmentation, CCA: inter-observer, 0.986; intra-observer, 0.954 to 0.993; ICA: inter-observer, 0.977; intra-observer, 0.958 to 0.978; ECA: inter-observer, 0.966; intra-observer, 0.884 to 0.937). Total carotid VWV measurements by manual (inter-observer, 0.922; intra-observer, 0.927 to 0.961) and semi-automated segmentation (inter-observer, 0.987; intra-observer, 0.968 to 0.989) were highly reliable. Semi-automated segmentation showed higher reliability than manual segmentation for both individual and total carotid VWV measurements.
3DUS carotid VWV measurements of the CCA are more reliable than measurements of the ICA and ECA. Total carotid VWV measurements are highly reliable. Semi-automated segmentation has higher reliability than manual segmentation.
在颈动脉粥样硬化评估中，三维超声（3DUS）测量颈动脉血管壁体积（VWV）优于传统二维超声。尽管已引入节省时间的半自动算法，但由于缺乏验证，尤其是广泛的可靠性分析，其临床应用仍然有限。本研究比较了3DUS测量颈动脉VWV时手动分割和半自动分割的观察者间及观察者内可靠性。
前瞻性采集了31例来自20名年龄>18岁、无既往卒中、短暂性脑缺血发作或心血管疾病的健康受试者的3DUS体积数据集。5名观察者对所有体积数据集进行手动和半自动分割。该过程重复5次。可靠性用组内相关系数表示，并辅以变异系数。
对于手动和半自动分割，使用颈总动脉（CCA）测量颈动脉VWV比使用颈内动脉（ICA）或颈外动脉（ECA）更可靠（手动分割，CCA：观察者间，0.935；观察者内，0.934至0.966；ICA：观察者间，0.784；观察者内，0.756至0.878；ECA：观察者间，0.732；观察者内，0.919至0.962；半自动分割，CCA：观察者间，0.986；观察者内，0.954至0.993；ICA：观察者间，0.977；观察者内，0.958至0.978；ECA：观察者间，0.966；观察者内，0.884至0.937）。手动（观察者间，0.922；观察者内，0.927至0.961）和半自动分割（观察者间，0.987；观察者内，0.968至0.989）测量的总颈动脉VWV高度可靠。对于个体和总颈动脉VWV测量，半自动分割显示出比手动分割更高的可靠性。
3DUS测量CCA的颈动脉VWV比测量ICA和ECA更可靠。总颈动脉VWV测量高度可靠。半自动分割比手动分割具有更高的可靠性。
