Document Detail


Clinical utility of multiplanar reformation in pulmonary CT angiography.
MedLine Citation:
PMID:  20028907     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study was to determine whether the view used, multiplanar or axial, for image interpretation at pulmonary CT angiography for suspected acute pulmonary embolism alters the diagnostic confidence, accuracy, and interpretation time of cardiothoracic radiology specialists and radiology residents. MATERIALS AND METHODS: Patients who underwent 50 consecutive pulmonary 64-MDCT angiographic examinations formed the study group (18 men, 32 women; mean age, 53 years; range, 19-93 years). Three blinded cardiothoracic faculty radiologists and three blinded radiology residents reviewed each case independently initially using only axial display mode and later using multiplanar reformation (MPR) in any x-, y-, or z-axis. The presence of pulmonary embolism in the main through subsegmental pulmonary arteries was scored on a 5-point scale; diagnostic confidence for the overall examination was scored on a 3-point scale; and interpretation time was recorded. A surrogate reference standard consisted of either faculty agreement or, in cases of disagreement, adjudication by another, senior faculty member. Statistical analysis included the Kendall coefficient (W), receiver operating characteristics curves, and a univariate repeated measures model. RESULTS: Interobserver agreement between specialists on the diagnosis of pulmonary embolism was good for axial viewing (W=0.72) and for MPR viewing (W=0.79). Interobserver agreement between residents was good for axial viewing (W=0.62) and for MPR viewing (W=0.70). Reader confidence improved among all readers with MPR viewing, but the difference did not reach statistical significance. Interpretation time with MPR was significantly longer for two of the three specialists and significantly shorter for two of the three residents. CONCLUSION: Use of MPR for viewing increased the reader agreement and interpretation time of cardiothoracic specialists but increased reader agreement between residents and might have decreased interpretation time. All readers had a trend toward increased confidence.
Authors:
Leandro A Espinosa; Aine M Kelly; Colleen Hawley; Radha Inampudi; Aamer Chughtai; Prachi Agarwal; Shokoufeh Khalatbari; James Myles; Ella Kazerooni
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  194     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-23     Completed Date:  2010-01-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  70-5     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiothoracic Imaging, Department of Radiology, University of Michigan Hospitals, B1G505 UH SPC 5028, 1500 E Medical Center Dr., Ann Arbor, MI 48109, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angiography / methods*
Clinical Competence
Contrast Media
Female
Humans
Iohexol / analogs & derivatives,  diagnostic use
Male
Middle Aged
Pulmonary Embolism / radiography*
ROC Curve
Radiographic Image Interpretation, Computer-Assisted / methods*
Tomography, X-Ray Computed / methods*
Grant Support
ID/Acronym/Agency:
UL1RR024986/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Contrast Media; 66108-95-0/Iohexol; 73334-07-3/iopromide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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