van Beek E J, Bakker A J, Reekers J A
Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands.
Radiology. 1996 Mar;198(3):721-4. doi: 10.1148/radiology.198.3.8628860.
To assess interobserver agreement in the interpretation of digital subtraction angiographic (DSA) images and conventional angiograms in patients with nondiagnostic lung scans.
One hundred thirty of 397 consecutive patients (65 men, 65 women; mean age, 57 years; age range, 18-92 years) in this prospective cohort study underwent angiography. Conventional, selective series were obtained between 1991 and 1992 in 45 patients, and intraarterial DSA series were obtained between 1992 and 1994 in 85 patients. All angiograms were read immediately by the attending radiologist, independently by two radiologists after 6 months, and later by means of consensus of the two radiologists.
Results of the two methods were comparable. Interobserver disagreement occurred in 20%-36% (n = 9-16) of patients with conventional images and 4%-11% (n = 3-9) of patients with DSA images. Initial diagnoses were changed after the images were reviewed by means of consensus in 20% and 12% of patients with conventional and DSA series, respectively. In 70% of these patients, initial findings were false-positive; in 25%, inconclusive; and in 5%, false-negative.
Interobserver agreement is better with selective, intraarterial DSA than with conventional techniques.
评估在解读非诊断性肺部扫描患者的数字减影血管造影（DSA）图像和传统血管造影时观察者间的一致性。
在这项前瞻性队列研究中，397例连续患者中的130例（65名男性，65名女性；平均年龄57岁；年龄范围18 - 92岁）接受了血管造影。1991年至1992年期间，45例患者获得了传统的选择性系列血管造影，1992年至1994年期间，85例患者获得了动脉内DSA系列血管造影。所有血管造影均由主治放射科医生立即阅读，6个月后由两名放射科医生独立阅读，随后通过两名放射科医生的共识进行解读。
两种方法的结果具有可比性。在传统图像患者中，观察者间的分歧发生率为20% - 36%（n = 9 - 16），在DSA图像患者中为4% - 11%（n = 3 - 9）。在通过共识对图像进行复查后，传统系列和DSA系列患者中分别有20%和12%的初始诊断发生了改变。在这些患者中，70%的初始发现为假阳性；25%为不确定；5%为假阴性。
与传统技术相比，选择性动脉内DSA的观察者间一致性更好。
