Geelhoed J J Miranda, Kleyburg-Linkers Veronica E, Snijders Sonja P E, Lequin Maarten, Nauta Jeroen, Steegers Eric A P, van der Heijden Albert J, Jaddoe Vincent W V
The Generation R Study Group (AE-006), Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
Pediatr Nephrol. 2009 Jul;24(7):1345-53. doi: 10.1007/s00467-009-1148-3. Epub 2009 Mar 12.
The aim of the investigation reported here was to assess the intraobserver and interobserver variability of renal measurements in children. The study comprised 56 paired measurements in 28 children (median age 7.5 years, range 3.0-15.0 years) without renal or ureterovesical anomalies. Intraobserver and interobserver reproducibility was assessed by repeated measurements of the left and right renal length, width, and thickness. Intraclass correlation coefficients (ICCs) with the corresponding 95% confidence interval (CI) were calculated. Bland and Altman plots were computed to assess the agreement of the measurements. Limits of agreement +/- 2 standard deviations (SD) for the mean differences in renal measurements were derived. Intraobserver ICCs ranged from 0.93 (left and right renal width and right renal thickness) to 0.99 (left renal length), and interobserver ICCs ranged from 0.64 (right renal thickness) to 0.90 (right renal length). Limits of agreement in the Bland and Altman plots ranged from -8.0 to 9.2% (intraobserver left renal width) to the widest limit from -18.0 to 19.2% (interobserver left renal length). Overall, this study demonstrated the good reproducibility and agreement of most renal dimensions in children measured by ultrasound (US). Based on these results, we conclude that US is an appropriate measure to assess renal dimensions in both clinical and epidemiological studies.
本文所报告的研究目的是评估儿童肾脏测量的观察者内和观察者间变异性。该研究纳入了28名无肾脏或输尿管膀胱异常的儿童（中位年龄7.5岁，范围3.0 - 15.0岁）的56对测量数据。通过重复测量左、右肾的长度、宽度和厚度来评估观察者内和观察者间的可重复性。计算了组内相关系数（ICC）及其相应的95%置信区间（CI）。绘制了Bland - Altman图以评估测量结果的一致性。得出了肾脏测量平均差异的一致性界限±2标准差（SD）。观察者内ICC范围为0.93（左、右肾宽度和右肾厚度）至0.99（左肾长度），观察者间ICC范围为0.64（右肾厚度）至0.90（右肾长度）。Bland - Altman图中的一致性界限范围从 - 8.0%至9.2%（观察者内左肾宽度）到最宽的 - 18.0%至19.2%（观察者间左肾长度）。总体而言，本研究表明超声（US）测量儿童大多数肾脏维度具有良好的可重复性和一致性。基于这些结果，我们得出结论，在临床和流行病学研究中，超声是评估肾脏维度的合适方法。
