查詢結果分析
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頁籤選單縮合
題 名 | Comparison of Automated 4D-MSPECT and Visual Analysis for Evaluating Myocardial Perfusion in Coronary Artery Disease=比較自動化4D-MSPECT與目測法對於冠狀動脈疾病的心肌灌注分析 |
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作 者 | 徐健欽; 陳毓雯; 郝繼隆; 張雲德; 李俊毅; 陳孝棟; 吳明昇; 吳榮州; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
卷 期 | 24:9 2008.09[民97.09] |
頁 次 | 頁445-452 |
分類號 | 415.213 |
關鍵詞 | 自動半定量分析; 冠狀動脈疾病; 心肌灌注掃描; 目測半定量分析; Automated semiquantitative scoring; Coronary artery disease; 4D-MSPECT; Myocardial perfusion imaging; Visual semiquantitative scoring; |
語 文 | 英文(English) |
中文摘要 | 本研究的目的在於評估使用自動化電腦軟體 (4D-MSPECT) 來分析心肌灌注掃描對於冠狀動脈疾病診斷的可行性與可重複性,並且與專科醫師目測評估的結果做比較。本研究包含了 60 位未知冠狀動脈疾病的患者進行雙同位素心肌灌注掃描,並在三個月內進行心導管檢查。設定 4D-MSPECT 以 17 區 5 分法半定量分析心肌灌注掃描, 產生自動總和壓力分數(A-SSS)、總和休息分數 (A-SRS) 和總和差異分數 (A-SDS)。一位核醫科專科醫師分析兩次來評估同一觀察者間差異。另一位資深核醫放射師分析一次與核醫科專科醫師分析的結果來評估不同觀察者間差異。由兩位核醫科專科醫師採用同樣的 17 區 5 分法,經討論後一致的評分結果產生目測總和壓力分數 (V-SSS)、總和休息分數 (V-SRS) 和總和差異分數 (V-SDS)。我們發現不管是同一觀察者或是不同觀察者以 4D-MSPECT 進行自動半定量分析均呈現優異的一致性與相關性。目測與軟體自動化對於心臟區域的半定量評分結果呈現中等程度的一致性,總和分數則呈現高度的相關性。以 ROC 分析法分析 V-SSS、V-SDS、A-SSS 和 A-SDS 這四種分數對冠狀動脈疾病的診斷,曲線下面積分別為 0.78 +/- 0.06、0.87 +/- 0.05、0.84 +/- 0.05 和 0.90 +/- 0.04,A-SDS 對冠狀動脈疾病的診斷優於 A-SSS 和 V-SSS,但 A-SDS 與 V-SDS 之間則沒有顯著的差異。如果用 V-SDS 大於等於 2 當作診斷冠狀動脈疾病的閾值,其靈敏度、特異度和正確率分別為 83.1%、76.5% 和 81.7%,用 A-SDS 大於等於 3 當作診斷冠狀動脈疾病的閾值,其靈敏度、特異度和正確率則分別為 79.1%、82.4% 和 80.0%。我們的結論是利用 4D-MSPECT 這個電腦軟體的自動化半定量分析心肌灌注掃描,對於冠狀動脈疾病的診斷具有高度的可重複性,而且與目測半定量分析的結果相當。 |
英文摘要 | The aim of this study was to assess the reproducibility and diagnostic performance for coronary artery disease (CAD) of an automated software package, 4D-MSPECT, and compare the results with a visual approach. We enrolled 60 patients without previously known CAD, who underwent dual-isotope rest Tl-201/stress Tc-99m sestamibi myocardial perfusion imaging and subsequent coronary angiography within 3 months. The automated summed stress score (A-SSS), summed rest score (A-SRS) and summed difference score (A-SDS) were obtained using a 17-segment five-point scale model with 4D-MSPECT. For intraobserver and interobserver variability assessment, automated scoring was done by a nuclear medicine physician twice and by a nuclear medicine technologist. The visual summed stress score (V-SSS), summed rest score (V-SRS), and summed difference score (V-SDS) were obtained by consensus of two nuclear medicine physicians. The intraobserver and interobserver agreements of automated segmental scores were excellent. The intraobserver and interobserver summed scores also correlated well. Agreements between visual and automated segmental scores were moderate (weighted κ of 0.55 and 0.50 for stress and rest images, respectively). Correlations between automated and visual summed scores were high, with correlation coefficients of 0.89, 0.85 and 0.82 for SSS, SRS and SDS, respectively (all p < 0.001). The receiver operating characteristic area under the curve for diagnosis of CAD by V-SSS, V-SDS, A-SSS and A-SDS were 0.78 +/- 0.06, 0.87 +/- 0.05, 0.84 +/- 0.05 and 0.90 +/- 0.04, respectively. A-SDS had better diagnostic performance than A-SSS and V-SSS (p = 0.043 and p = 0.032, respectively), whereas there was no statistically significant difference between A-SDS and V-SDS (p = 0.56). Using V-SDS ≥ 2 as a diagnostic threshold, the sensitivity, specificity, and accuracy for CAD were 83.7%, 76.5% and 81.7%, respectively. Using A-SDS ≥ 3 as a diagnostic threshold, the sensitivity, specificity, and accuracy for CAD were 79.1%, 82.4% and 80.0%, respectively. In conclusion, the reproducibility of automated semiquantitative analysis with 4D-MSPECT was excellent. The diagnostic performance of automated semiquantitative analysis with 4D-MSPECT was comparable with the visual approach. |
本系統中英文摘要資訊取自各篇刊載內容。