Reproducibility of coronary plaque detection and characterization using low radiation dose coronary computed tomographic angiography in patients with intermediate likelihood of coronary artery disease (ReSCAN study)

作者：Ovrehus Kristian Altern^*; Marwan Mohamed; Botker Hans Erik; Achenbach Stephan; Norgaard Bjarne Linde

来源：International Journal of Cardiovascular Imaging, 2012, 28(4): 889-899.

DOI：10.1007/s10554-011-9895-1

• Coronary artery disease
• X ray computed tomography
• Coronary angiography
• Atherosclerotic plaques
• Reproducibility
• Dual source CT

The purpose of this study is to evaluate the interscan, interobserver and intraobserver agreement for coronary plaque detection, and characterization using low radiation dose high-pitch spiral acquisition coronary CT angiography (CTA). Two experienced observers independently evaluated coronary CTA datasets from 50 consecutive patients undergoing two 128-slice dual source CT scans within 12 days. Mean (+/- SD) estimated radiation exposure was 1.5 +/- A 0.2 mSv per scan. Observers recorded the presence and characterization of coronary plaques as non-calcified or calcified. A %26quot;segment involvement score%26quot; (SIS) was computed by summing the numbers of segments with any coronary plaque per patient. Reproducibility was assessed using kappa (kappa) statistics, paired t test and Bland-Altman analyses. Interscan, interobserver, and intraobserver agreement (kappa-values) for detection of any or calcified plaques were 83-94% (kappa-values 0.57-0.85), and 67-84% (0.31-0.67) for non-calcified plaques on a patient level. No significant difference was observed in mean interscan or interobserver SIS. Mean (95% CI) intraobserver SIS difference was -0.88 (-1.25; -0.51), P %26lt; 0.001, with limits of agreement from -4.7 to 2.9. Low radiation dose high-pitch coronary CTA permits detection of any or calcified plaques with high interscan, interobserver, intraobserver agreement. However, variability for the detection of non-calcified plaque is substantial.

• 出版日期2012-4