Poster électronique

Quantification du calcium coronaire en tomodensitométrie : évaluation d'une stratégie
B LAMBERT, A REDHEUIL, G FRIJA, E MOUSSEAUX, S FONTAINE, ML DARGERE, A AZARINE, M BENSALLAH, E BRUGUIERE - PARIS - FRANCE
Congrès 2011
Résumé
Objectifs
Évaluer la corrélation des résultats des scores calciques coronaires obtenus par trois manipulateurs par rapport à une lecture de référence.
Matériels et méthodes
Cent sujets asymptomatiques à risque cardiovasculaire intermédiaire (âge moyen 59 ans+/-8, 82%hommes) ont été inclus. Les acquisitions ont été réalisées avec synchronisation ECG prospective en coupe de 2.5mm sur un scanner 64 barrettes. Le score calcique coronaire total (CAC) a été quantifié selon Agatston. Une lecture radiologique consensuelle a été considérée comme référente pour comparaison avec les lectures de trois manipulateurs (M1, M2, M3).La relation entre les scores manipulateurs et la référence a été étudiée en régression linéaire et la corrélation entre classe diagnostiques (CAC=0, 1-99, 100-399, >=400) par analyse Kappa.
Résultats
Les pentes de régression (IC95 %) entre manipulateurs et référence étaient respectivement : 0.97 (0.94-0.99), 1.08(1.06-1.11), 1.03(1.01-1.04), p<0.0001. par ailleurs la différence est légèrement plus importante sur les scores les plus élevés. Les corrélations (K) en classes de CAC étaient : M1 : 0.9458, M2 : 0.9055, M3 : 0.9459, p<0,001.
Conclusion
Les scores calciques coronaires quantifiés par les manipulateurs sont très proches d'une lecture de référence et aucune erreur de plus d'une classe de CAC n'a été constatée. La délégation à des manipulateurs entrainés de la quantification du CAC semble envisageable.
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