[超声心动图自动心内膜边界检测系统的准确性及临床适用性：相关性与偏差分析]

[Accuracy and clinical applicability of the echocardiographic automated endocardial boundary detection system: correlation and bias analysis].

作者信息

González Torrecilla E, García Fernández M A, San Román D, Barambio M, Moreno M M, Alberca M T, Bermejo J, Fernández de Bobadilla J, Delcán J L

机构信息

Departamento de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid.

出版信息

Rev Esp Cardiol. 1995 Apr;48(4):235-44.

PMID:7740144

Abstract

INTRODUCTION AND OBJECTIVES

Automated edge detection of endocardial borders is a new echo system that permits on-line delineation and tracking of blood-tissue interface and offers promise for measuring cyclic changes in cavity area and the assessment of left ventricular function on-line. Its accuracy has only been analyzed by linear regression and its applicability in unselected patients is not clearly established.

METHODS

We analyzed the accuracy and clinical applicability of the system in 150 patients. Its accuracy was assessed not only by linear regression but also by bias analysis by comparing the results of the system with those obtained by manual tracing from parasternal short-axis and apical 4 chamber views.

RESULTS

We obtained satisfactory studies with this system in at least one of the two echo views in 66% of patients: 47% from 4-chambers view, 43% from parasternal short-axis view and 24.6% from both echo views. A visual semiquantitative assessment of left ventricular function could be performed in 88.6% of patients (p < 0.001). On-line and hand-traced left ventricular areas there well correlated, but fractional area change values from both methods correlated less closely. 95% limits of agreement between both methods were: 2.8 +/- 5.5 cm2 (end-diastolic area), 1 +/- 4.4 cm2 (end-systolic area) and 1.2 +/- 23% (fractional area change) in short-axis parasternal view; in apical 4-chambers view these limits were: 1.16 +/- 6.4 cm2,--1.1 +/- 6 cm2 and 7.3 +/- 16%, respectively.

CONCLUSIONS

Although the correlations between left ventricular areas from both methods were close the limits of agreement exceeded our acceptable range of reproducibility. Fractional area change showed only moderate correlations and a lack of agreement with off-line method. Poor image quality of the conventional echo still limits the clinical applicability of the current automated edge detection system.

摘要

引言与目的

心内膜边界的自动边缘检测是一种新的超声心动图系统，它能够在线描绘和追踪血液 - 组织界面，并有望用于测量心腔面积的周期性变化以及在线评估左心室功能。其准确性仅通过线性回归进行了分析，且在未经过筛选的患者中的适用性尚未明确确立。

方法

我们分析了该系统在150例患者中的准确性和临床适用性。不仅通过线性回归评估其准确性，还通过偏差分析进行评估，即将该系统的结果与从胸骨旁短轴和心尖四腔视图手动追踪获得的结果进行比较。

结果

在66%的患者中，我们使用该系统在至少两个超声视图中的一个中获得了满意的研究结果：47%来自四腔视图，43%来自胸骨旁短轴视图，24.6%来自两个超声视图。88.6%的患者能够进行左心室功能的视觉半定量评估（p < 0.001）。在线测量和手动描绘的左心室面积相关性良好，但两种方法的面积变化分数值相关性较差。两种方法之间的95%一致性界限为：胸骨旁短轴视图中，舒张末期面积为2.8±5.5 cm²，收缩末期面积为1±4.4 cm²，面积变化分数为1.2±23%；在心尖四腔视图中，这些界限分别为1.16±6.4 cm²、 - 1.1±6 cm²和7.3±16%。