CAJ | 학술논문

目的以宫颈癌为研究模型,运用三维能量多普勒和计算机辅助分析(VOCAL)软件,比较其手动描绘法和球自动法轮廓取样的重复性.方法观察者1运用该技术前瞻性分析80名宫颈癌患者,分别使用手动描绘法和球自动法二次测量目标器官内各血管参数,包括血管形成指数(VI)、血流指数(FI)、血管血流指数(VFI).随机选取40名患者由观察者2进行二次测量,分别用手动描绘法和球自动法分析,方法同前.计算组问重复性、组内重复性,一致性范围、95%可信区间,并用ANOVA法分析测量变量和组间测量结果差别的关系.结果每位观察者各自手动描绘法的重复性均优于球自动法(0.92～0.99对0.75～0.94),手动描绘法与球自动法比较,其标准偏差小,一致性区间窄,95%可信区间窄,相关系数高.手动描绘法组间重复性与组内重复性相当(0.95～0.97对0.92～0.99),而球自动法组间重复性明显降低(0.52～0.72).结论对于目标器官内血管的测定手动描绘轮廓取样法测量结果较球自动轮廓取样法更稳定,重复性更好,尤其适用于不规则组织的测量.
목적 이궁경암위연구모형,운용삼유능량다보륵화계산궤보조분석(VOCAL)연건,비교기수동묘회법화구자동법륜곽취양적중복성.방법 관찰자1운용해기술전첨성분석80명궁경암환자,분별사용수동묘회법화구자동법이차측량목표기관내각혈관삼수,포괄혈관형성지수(VI)、혈류지수(FI)、혈관혈류지수(VFI).수궤선취40명환자유관찰자2진행이차측량,분별용수동묘회법화구자동법분석,방법동전.계산조문중복성、조내중복성,일치성범위、95%가신구간,병용ANOVA법분석측량변량화조간측량결과차별적관계.결과 매위관찰자각자수동묘회법적중복성균우우구자동법(0.92～0.99대0.75～0.94),수동묘회법여구자동법비교,기표준편차소,일치성구간착,95%가신구간착,상관계수고.수동묘회법조간중복성여조내중복성상당(0.95～0.97대0.92～0.99),이구자동법조간중복성명현강저(0.52～0.72).결론 대우목표기관내혈관적측정수동묘회륜곽취양법측량결과교구자동륜곽취양법경은정,중복성경호,우기괄용우불규칙조직적측량.
Objective To assess the reproducibility of vascularization measurement in cervical carcinoma using transvaginal three-dimensional power Doppler angiography (3D-PDA) with virtualorgan computer-aided analysis ( VOCAL), and compare the reproducibility of two different contour mode (manual and automatic mode) of VOCAL. Methods Eighty patients with cervical carcinoma were examined by observer 1 using transvaginal 3D-PDA. The two acquired volume datasets were analyzed using manual and sphere automatic contour mode of the VOCAL imaging program for assessing carcinoma vascularization index( VI), flow index(FI), and vascularization flow index(VFI). Forty patients of them were examined randomly by observer 2 by the same method. Reproducibility of vascularity measurement was assessed by calculating intraclass (intra-CC) and interclass (inter-CC) , limits of agreement, 95% confidence interval definition. The contribution of various factors (examiner, measurement, contour mode and patient) to intrasubject variance was estimated using different analysis of variance models (ANOVA). Results For intraobserver,manual contour mode was more valid than sphere automatic contour mode for each observer (0. 92～0. 99 vs 0. 75～0. 94) ,and it also had smaller standard deviation,narrower limit of agreement range, 95% confidence interval and higher intra-cc than those of sphere automatic contour mode. Interobserver agreement of manual contour vascular measurements was similar to the intraobserver agreement for manual contour vascular measurements ( 0. 89 ～ 0. 97 vs 0. 92 ～ 0. 99 ) , but interobserver agreement for sphere automatic contour vascular measurements dramatically reduced (0. 52～0. 72). Conclusions Manual contour mode for 3D-PDA vascular measurement has better reproduciblity than sphere automatic contour mode, especially useful for irregular shape tissue.