当前位置： SCI文献检索 > CLINICAL RADIOLOGY期刊下所有文献 > ECG-gated multislice spiral CT for diagnosis of acute pulmonary embolism.

ECG-gated multislice spiral CT for diagnosis of acute pulmonary embolism.

Abstract：

AIM:The purpose of this study was to determine the feasibility of echocardiogram (ECG)-gated multi-slice CT angiography (MCTA) in patients with clinical suspicion of acute venous thromboembolism (VTE), to investigate the effect of ECG-gating on cardiac motion artefacts, and to determine the diagnostic reader agreement of ECG-gated MCTA in comparison with conventional MCTA. MATERIALS AND METHODS:Forty-eight consecutive patients were prospectively enrolled and randomly underwent ECG-gated (n=25, group 1) or non-ECG-gated (n=23, group 2) eight-slice pulmonary MCTA. Image data were evaluated by three independent chest radiologists with respect to the presence or absence of emboli at different arterial levels (main, lobar, segmental, and subsegmental arteries), and with regard to cardiac motion artefacts. Statistical tests used to calculate inter-observer agreement were weighted kappa statistics, extended kappa statistics and confidence indices indicating three-reader agreement accuracy. RESULTS:Twenty-seven patients (56.3%) were diagnosed to have pulmonary embolism (13 from group 1, 14 from group 2). Cardiac motion artefacts were significantly more frequent in group 2 (70% in group 2 versus 13% in group 1, p=0.0001). The overall diagnostic agreement was excellent with both MCTA techniques (three-reader confidence index for all vascular territories: 0.76 and 0.84 for groups 1 and 2, respectively (extended kappa=0.69 and 0.78, respectively); three-reader confidence index for diagnosis of VTE: 0.94 and 0.85 for groups 1 and 2, respectively (extended kappa=0.91 and 0.73, respectively), weighted kappa=0.81-0.83 and 0.92-0.95 for groups 1 and 2, respectively, and did not differ significantly between the two groups. In addition there was no significant difference of inter-observer agreement in either group at any assessed pulmonary arterial level. CONCLUSION:ECG-gated pulmonary MCTA is feasible in patients with clinical suspicion of VTE. However, ECG-gated image acquisition did not influence the diagnostic reader agreement accuracy and inter-observer agreement of MCTA. Hence, it does not appear to be advantageous for the MCTA diagnosis of pulmonary embolism.

journal_name

Clin Radiol

journal_title

Clinical radiology

authors

Marten K,Engelke C,Funke M,Obenauer S,Baum F,Grabbe E

doi

10.1016/s0009-9260(03)00348-9

subject

Has Abstract

pub_date

2003-11-01 00:00:00

pages

862-8

issue

eissn

0009-9260

issn

1365-229X

pii

S0009926003003489

journal_volume

pub_type

临床试验,杂志文章,随机对照试验

在线工具

ECG-gated multislice spiral CT for diagnosis of acute pulmonary embolism.