Bjørnstad K, Aakhus S, Torp H G
Department of Medicine, University Hospital of Trondheim, Norway.
Int J Card Imaging. 1997 Apr;13(2):105-14. doi: 10.1023/a:1005752331136.
This study assessed interobserver and intraobserver variation and diagnostic accuracy during 25 dipyridamole stress echocardiography tests interpreted with different analysis systems: a) computer display of high frame rate digital cineloops (47 frames/s); b) computer display of lower frame rate digital cineloops (24 frames/s); and c) videotape recordings. The majority of the patients (84%) had documented coronary artery disease with baseline wall motion abnormalities due to previous myocardial infarctions and/or coronary bypass surgery, thus comprising a population with difficult interpretation of stress echocardiography. Diagnostic accuracy was assessed using coronary angiography as reference method. Interobserver and intraobserver agreement was highest when analysis was performed from computer-displayed cineloops, 96 and 92%, respectively, compared to 84 and 80% respectively, using videotape recordings. Sensitivity for identification of coronary artery stenosis was similar using digital cineloops with high frame rate or videotape recordings (67% to 80% for both systems), and tended to be lower using cineloops with lower frame rate for analysis (53%). Inter- and intraobserver differences for wall motion score index were not significantly influenced by the analysis system. We conclude that computer assisted analysis with high frame rate of the displayed cineloops provides optimal observer agreement and diagnostic accuracy in the same range as videotape analysis in patients undergoing stress echocardiography.
本研究评估了在使用不同分析系统解读的25次双嘧达莫负荷超声心动图检查中观察者间和观察者内的变异性以及诊断准确性：a）高帧率数字电影环（47帧/秒）的计算机显示；b）低帧率数字电影环（24帧/秒）的计算机显示；以及c）录像带记录。大多数患者（84%）有冠状动脉疾病的记录，因既往心肌梗死和/或冠状动脉搭桥手术存在基线壁运动异常，因此构成了一个负荷超声心动图解读困难的人群。以冠状动脉造影作为参考方法评估诊断准确性。当从计算机显示的电影环进行分析时，观察者间和观察者内的一致性最高，分别为96%和92%，而使用录像带记录时分别为84%和80%。使用高帧率数字电影环或录像带记录识别冠状动脉狭窄的敏感性相似（两种系统均为67%至80%），而使用低帧率电影环进行分析时敏感性往往较低（53%）。壁运动评分指数的观察者间和观察者内差异不受分析系统的显著影响。我们得出结论，对于接受负荷超声心动图检查的患者，使用高帧率显示电影环的计算机辅助分析可提供与录像带分析相同范围内的最佳观察者一致性和诊断准确性。
