Kornaat Peter R, Ceulemans Ruth Y T, Kroon Herman M, Riyazi Naghmeh, Kloppenburg Margreet, Carter Wayne O, Woodworth Thasia G, Bloem Johan L
Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
Skeletal Radiol. 2005 Feb;34(2):95-102. doi: 10.1007/s00256-004-0828-0. Epub 2004 Oct 8.
To develop a scoring system for quantifying osteoarthritic changes of the knee as identified by magnetic resonance (MR) imaging, and to determine its inter- and intra-observer reproducibility, in order to monitor medical therapy in research studies.
Two independent observers evaluated 25 consecutive MR examinations of the knee in patients with previously defined clinical symptoms and radiological signs of osteoarthritis. We acquired on a 1.5 T system: coronal and sagittal proton density- and T2-weighted dual spin echo (SE) images, sagittal three-dimensional T1-weighted gradient echo (GE) images with fat suppression, and axial dual turbo SE images with fat suppression. Images were scored for the presence of cartilaginous lesions, osteophytes, subchondral cysts, bone marrow edema, and for meniscal abnormalities. Presence and size of effusion, synovitis and Baker's cyst were recorded. All parameters were ranked on a previously defined, semiquantitative scale, reflecting increasing severity of findings. Kappa, weighted kappa and intraclass correlation coefficient (ICC) were used to determine inter- and intra-observer variability.
Inter-observer reproducibility was good (ICC value 0.77). Inter- and intra-observer reproducibility for individual parameters was good to very good (inter-observer ICC value 0.63-0.91; intra-observer ICC value 0.76-0.96).
The presented comprehensive MR scoring system for osteoarthritic changes of the knee has a good to very good inter-observer and intra-observer reproducibility. Thus the score form with its definitions can be used for standardized assessment of osteoarthritic changes to monitor medical therapy in research studies.
开发一种评分系统，用于量化磁共振（MR）成像所识别的膝关节骨关节炎变化，并确定其在观察者间和观察者内的可重复性，以便在研究中监测医学治疗效果。
两名独立观察者对25例先前已确定有骨关节炎临床症状和放射学征象的患者的膝关节进行了连续MR检查。我们在1.5T系统上采集了：冠状面和矢状面质子密度加权和T2加权双自旋回波（SE）图像、带有脂肪抑制的矢状面三维T1加权梯度回波（GE）图像以及带有脂肪抑制的轴向双涡轮SE图像。对软骨损伤、骨赘、软骨下囊肿、骨髓水肿以及半月板异常的存在情况进行评分。记录积液、滑膜炎和腘窝囊肿的存在情况及大小。所有参数均按照先前定义的半定量量表进行分级，反映观察结果的严重程度增加。使用kappa、加权kappa和组内相关系数（ICC）来确定观察者间和观察者内的变异性。
观察者间的可重复性良好（ICC值为0.77）。各个参数的观察者间和观察者内可重复性良好至极优（观察者间ICC值为0.63 - 0.91；观察者内ICC值为0.76 - 0.96）。
所提出的用于膝关节骨关节炎变化的综合MR评分系统在观察者间和观察者内具有良好至极优的可重复性。因此，该评分表及其定义可用于标准化评估骨关节炎变化，以在研究中监测医学治疗效果。
