Koroner Bilgisayarlı Tomografi Anjiyografi Çekilen Hastalarda Sistolik Ve Diyastolik Fazlarda Pulmoner Arter Çapının Değişen Kesit Kalınlıklarında Yapılan Ölçümlerinde Gözlemciler Arası Farklılığın Belirlenmesi

Abstract

There are studies showing a correlation between pulmonary artery diameter (PAD) and pulmonary artery pressure on computed tomography (CT). In these studies, a thoracic CT examination was performed to evaluate PAD. One of the objectives of our study was to demonstrate the clinical significance of possible differences by measuring the widest and narrowest axial PAD in the cardiac cycle from coronary CT angiography images. Our other objectives in this study were to show whether the use of different cross-sectional thickness results in a difference in PAD measurement and determination of interobserver differences in the measurements of PAD. In order to determine the varying cross-sectional thickness and interobserver differences of the PAD measurement, coronary CT angiography examinations of 160 patients were examined retrospectively by three radiology assistants with a thickness of 1 mm, 3 mm and 5 mm, respectively. Also in order to determine the width of the PAD in the systole and diastole phases, selected 101 patients different from the previous ones who underwent coronary CT angiography and then their images was reconstructed during a cardiac cycle and was measured by the two radiology assistants widest and narrowest PAD. Although statistical significance (p <0,05) was found in the measurements of two radiologists at different cross-sectional thicknesses, the maximum difference in the different slice thickness of the same patient is found 0.5 mm. This situation is not clinically significant in patient management. A high correlation was found between radiologists in the measurement of both groups of patients (in the first patient group, the intraclass correlation coefficient between 3 radiologists was 95%, and the correlation between 2 radiologists in the second patient group was 99%). On the other hand, the mean difference was found 3.5 mm (p <0.001) at PAD measurement in the systole and diastole phases in 101 patients. In daily practice, 5 mm cross-sectional images are used when evaluating the mediastinum in thorax CT. Since there is no clinically significant difference in the PAD measurement compared to the 1 mm sections, it is not necessary to re-evaluate the thinnest slice thickness. A high degree of similarity with other studies among radiologists in PAD measurement is giving confidence in the reproducibility of this measurement by different persons. The differences in the systole and diastole phases, which were the widest and narrowest of the PAD, were found to be significant enough to affect the clinical interpretation.