■为了研究从四维(4D)CT血管造影(RSCT)计算的心内膜区域缩短是否可以用作决策分类器来检测左心室(LV)壁运动异常(WMA)的存在。
■一百项心电图门控心脏4DCT研究(平均年龄,对2018年4月至2020年12月进行的59岁±14[SD];61例男性患者)进行了回顾性评估。三位专家将16个美国心脏协会(AHA)节段中的每个节段的LV壁运动标记为正常或异常;他们还测量了每个节段中一次心跳的RSCT峰值。将数据集平均分成训练组和验证组。在培训期间,使用个体等效指数(γ)评估RSCT阈值与专家检测WMA的互换性,并确定了达到最大一致性的峰值RSCT(RSCT*)的最佳阈值。然后使用验证组验证RSCT*,并评估了AHA节段特异性阈值的效果。使用κ统计来评估一致性。
■最佳阈值,RSCT*为-0.19,当应用于所有AHA节段时,导致高协议(协议率=92.17%,κ=0.82)和与专家的互换性(γ=-2.58%)。同样的RSCT*在验证组中也取得了很高的一致性(一致性率=90.29%,κ=0.76,γ=-0.38%)。使用AHA节段特异性阈值(范围:跨AHA节段的0.16至-0.23)略微改善了一致性(1.79%增加)。
■RSCT阈值可与专家视觉分析在检测来自4DCT的分段WMA时互换,并可用作客观决策分类器。关键词:CT,左心室,区域性心内膜缩短,墙运动异常补充材料可用于本文。©RSNA,2023年。
UNASSIGNED: To investigate whether endocardial regional shortening computed from four-dimensional (4D) CT angiography (RSCT) can be used as a decision classifier to detect the presence of left ventricular (LV) wall motion abnormalities (WMAs).
UNASSIGNED: One hundred electrocardiographically gated cardiac 4D CT studies (mean age, 59 years ± 14 [SD]; 61 male patients) conducted between April 2018 and December 2020 were retrospectively evaluated. Three experts labeled LV wall motion in each of the 16 American Heart Association (AHA) segments as normal or abnormal; they also measured peak RSCT across one heartbeat in each segment. The data set was split evenly into training and validation groups. During training, interchangeability of RSCT thresholding with experts to detect WMA was assessed using the individual equivalence index (γ), and an optimal threshold of the peak RSCT (RSCT*) that achieved maximum agreement was identified. RSCT* was then validated using the validation group, and the effect of AHA segment-specific thresholds was evaluated. Agreement was assessed using κ statistics.
UNASSIGNED: The optimal threshold, RSCT* of -0.19, when applied to all AHA segments, led to high agreement (agreement rate = 92.17%, κ = 0.82) and interchangeability with experts (γ = -2.58%). The same RSCT* also achieved high agreement in the validation group (agreement rate = 90.29%, κ = 0.76, γ = -0.38%). The use of AHA segment-specific thresholds (range: 0.16 to -0.23 across AHA segments) slightly improved agreement (1.79% increase).
UNASSIGNED: RSCT thresholding was interchangeable with expert visual analysis in detecting segmental WMA from 4D CT and may be used as an objective decision classifier.Keywords: CT, Left Ventricle, Regional Endocardial Shortening, Wall Motion Abnormality Supplemental material is available for this article. © RSNA, 2023.