Inter-rater and scan-rescan reproducibility of the detection of intracranial atherosclerosis on contrast-enhanced 3D vessel wall MRI
Inter-rater and scan-rescan reproducibility of the detection of intracranial atherosclerosis on contrast-enhanced 3D vessel wall MRI
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DOI：
10.1259/bjr.20180973
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发表时间：
2019-01-01
影响因子：
2.6
通讯作者：
Yuan, Chun
中科院分区：
文献类型：
--
作者：
Mossa-Basha, Mahmud;Watase, Hiroko;Yuan, Chun
目的：目的是建立多层造影剂三维增强颅内血管壁（IVW） MRI方案在颅内动脉粥样硬化检测中的扫描间、扫描间和扫描内的可重复性，该方案获得0.6mm（内插0.3mm）各向同性分辨率。方法：前瞻性招募已确定颅内动脉粥样硬化的受试者，并在2周内进行两次增强三维IVW扫描。四名具有不同程度血管壁成像解释经验的评分员，通过反复训练的过程，制定了无斑块、可能斑块和确定斑块类别的斑块识别指南。使用这些指导方针，评分者成对地审查病例（共识评分），而对另一对的解释、临床报告和患者历史不知情。研究者对每位患者19段动脉粥样硬化斑块的存在和位置进行了检查。评估扫描间、扫描间和扫描内的重现性。结果：19名受试者被扫描两次，共检查了361个总节段，分析了304-324个可评估的节段进行了不同的重复性评估。对可能和确定斑块的总体评分间一致性为88.9% [kappa= 0.73: 95%可信区间（CI）（0.62-0.81）]，扫描间/评分间一致性为82.1% [kappa= 0.58；95% CI(0.48-0.70)]，扫描间/评分间一致性为84.5% [kappa = 0.64；95%ci(0.51 - 0.76)]。结论：对比增强IVW成像，利用详细的斑块定义指南进行图像审查，可以作为颅内动脉粥样硬化评估的一种可重复性技术。知识进展：这项工作首次建立了IVW在有对照和无对照的情况下进行斑块鉴定的可重复性。造影剂的再现性很重要，因为大多数IVW应用依赖于病灶增强。
Objective: The objective is to establish interscan, inter- and intra-rater reproducibility of a multicontrast three-dimensional contrast-enhanced intracranial vessel wall (IVW) MRI protocol with 0.6mm acquired (0.3mm interpolated) isotropic resolution in the detection of intracranial atherosclerosis.Methods: Subjects with established intracranial atherosclerosis were prospectively recruited and underwent two contrast-enhanced three-dimensional IVW scans within a 2-week period. Four raters with varying degrees of vessel wall imaging interpretation experience, through an iterative training process developed guidelines for plaque identification with no, possible and definite plaque categories. Using these guidelines, the raters reviewed the cases in pairs (consensus rating), while blinded to the interpretations of the other pair, clinical reports and patient history. The rater pairs reviewed 19 segments per patient for the presence and location of atherosclerotic plaques. Inter-scan, inter rater and intra rater reproducibility were assessed.Results: 19 subjects were scanned twice, with 361 total segments reviewed and 304-324 evaluable segments analyzed in the different reproducibility assessments. Overall inter-rater agreement for possible and definite plaque was 88.9 % [kappa= 0.73: 95% confidence interval (CI) (0.62-0.81)], inter-scan/intra-rater agreement was 82.1 % [kappa = 0.58; 95% CI (0.48-0.70)] and inter-scan/inter-rater agreement of 84.5% [kappa = 0.64; 95%CI (0.51 - 0.76)].Conclusion: Contrast-enhanced IVW imaging, with the utilization of detailed plaque definition guidelines for image review, can be a reproducible technique for the evaluation of intracranial atherosclerosis.Advances in knowledge: This work is the first to establish reproducibility of IVW for plaque identification with and without contrast. Reproducibility using contrast is important as most IVW applications rely on lesion enhancement.