Accuracy and interobserver variability of coronary cineangiography: a comparison with postmortem evaluation.
Accuracy and interobserver variability of coronary cineangiography: a comparison with postmortem evaluation.
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DOI：
10.1016/s0735-1097(84)80171-0
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发表时间：
1984-05
影响因子：
24
通讯作者：
Neil Trask;R. Califf;M. J. Conley;Yihong Kong;Robert H. Peter;Kerry L. Lee;Donald B. Hackel;Galen S. Wagner
中科院分区：
文献类型：
--
作者：
Neil Trask;R. Califf;M. J. Conley;Yihong Kong;Robert H. Peter;Kerry L. Lee;Donald B. Hackel;Galen S. Wagner
对27例心导管术后6个月内死亡的患者的尸检结果进行了两名独立观察员对冠状动脉造影解释的准确性测试。我们还评估了不同血管造影医师在血管造影解释上的差异。2例患者冠状动脉正常，其余25例患者有明显的冠状动脉疾病。明显狭窄定义为管腔直径缩小75%或更大。在326个可以在死后评估的冠状动脉段中，15%不能通过血管造影评估。两位观测者的总体准确度分别为89%和88%，其中左主干的准确度分别为96%和100%，左前降支的准确度分别为91%和93%，右冠状动脉的准确度分别为84%和86%，左旋冠状动脉的准确度分别为89%和79%。在70%以上的主要血管中，血管造影评估远端到重要近端病变的管腔状态是可能的，两名观察者的准确率均为86%。在96条远端血管造影不充分混浊的血管中，49条（52%）未发现明显病变。两位血管造影师对340个冠状动脉段中86%的评估结果一致。左主干、右冠状动脉和左冠状动脉前降支的一致性显著优于左旋冠状动脉（p < 0.05）。244段充分混浊，经两名血管造影师评估，准确率为93%。因此，血管造影可用于评估冠状动脉解剖具有高度的准确性和最小的观察者之间的差异。
The accuracy of interpretation of coronary cineangiography by two independent observers was tested against postmortem findings in 27 patients who died within 6 months of cardiac catheterization. Variations in cineangiographic interpretations between the angiographers were also evaluated. Two patients had normal coronary arteries, while the remaining 25 patients had significant coronary artery disease. Significant stenosis was defined as 75% or greater reduction in luminal diameter. Of 326 coronary segments that could be evaluated postmortem, 15% could not be evaluated cineangiographically. The respective overall accuracy of the two observers was 89 and 88% with an accuracy of 96 and 100% for the left main coronary artery, 91 and 93% for the left anterior descending artery, 84 and 86% for the right coronary artery and 89 and 79% for the left circumflex coronary artery. Cineangiographic assessment of luminal status distal to a significant proximal lesion was possible in more than 70% of major vessels with accuracy levels of 86% for both observers. Of 96 distal vessels inadequately opacified cineangiographically, 49 (52%) were found to be free of significant lesions.Both angiographers agreed in their assessment of 86% of the 340 coronary segments. Interobserver agreement was significantly better for the left main, right and left anterior descending coronary arteries than for the left circumflex coronary artery (p < 0.05). Accuracy was 93% for 244 segments that were adequately opacified and assessed the same by both angiographers. Cineangiography can thus be used to evaluate coronary anatomy with a high degree of accuracy and minimal interobserver variability.