超声检测颈动脉内-中膜厚度的重复性评价

Reproducibility of ultrasonic measurement of carotid artery intima-media thickness

目的评价“十一五”国家科技支撑计划《冠心病早期诊断和综合治疗技术体系的研究》之动脉粥样硬化性疾病临床前病变队列研究中，超声检测颈动脉内一中膜厚度（intima—media thickness，IMT）的重复性，论证其作为主要研究指标的可靠性。方法抽取10例受检者，分别使用不同超声仪各检查1次，评价仪器间IMT检测重复性；2个中心各抽取2名超声医生，分别独立对共15例受检者进行重复检查，评价检查者自身及检查者间重复性；抽取20份图像，同一阅读者重复阅读2次，参考阅读者阅读1次，评价阅读者自身及阅读者间重复性。所有图像均行中心阅读测量。结果平均IMT的测量均差（meandifference，MD）在仪器间、检查者自身问、不同检查者间、测量者自身间、不同测量者间分别为（0．028±0．017）mm、（0．048±0．052）mgn、（0．035±0．022）mm、（0．030±0．032）mm、（0．081±0．043）mm；最大IMT的上述测值依次为（0．047±0．029）mm、（0．090±0．09）mm、（0．055±0．044）mm、（0．062±0．053）mm、（0．085±0．050）mm。结论平均IMT测量重复性优于最大IMT，且测量点越多，重复性越佳。与国外资料相比，本课题颈动脉超声测量IMT重复性良好。

Objective To evaluate the reproducibility of ultrasonic measurement of carotid artery intima media thickness（IMT） under the study condition of the project of Establishment of an Integrated System for CHD Prevention and Treatment. Methods Ten subjects were scanned twice using 2 different type ultrasound systems （used by 2 field centers separately） to evaluate the inter equipment variability. Randomly selected 2 sonographers from each center attended the reproducibility test. Fifteen subjects were scanned twice by the sonographers independently to evaluate the intra and inter operator variability. Twenty image sequences were read twice by a single reader and once by an experienced reader to evaluate the intra and inter reader variability. All images were center read. Results The mean difference of mean IMT measurements of inter equipment, average intra and inter operator,and average intra and inter reader were （0. 028 ± 0. 017）mm,（0. 048 ± 0. 052）mm, （0. 035 ± 0. 022）mm, （0. 030 ± 0. 032） mm,and （0. 081 ± 0. 043） mm,respectively,while the values of max IMT were （0. 047 ± 0. 029） mm, （0. 090 ± 0.09） mm, （0. 055 ± 0.044）mm,（0.062±0.053）mm,and （0.085 ±0.050）mm. Conclusions Mean IMT measurement is more reproducible than max IMT. The more sites measured,the better reproducibiliby can achive. Comparing with published studies,the reproducibility of IMT measurement in our study is satisfied.