Department of Radiology, Hospital Quirón, Valencia, Spain; Spanish Back Pain Research Network and Scientific Department, Fundación Kovacs, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain.
Radiology. 2010 Mar;254(3):809-17. doi: 10.1148/radiol.09090706. Epub 2010 Feb 1.
To evaluate intra- and interobserver agreement for the interpretation of lumbar 1.5-T magnetic resonance (MR) images in a community setting.
The study design was approved by the Institutional Review Board of the Ramón y Cajal Hospital. According to Spanish law, for this type of study, no informed consent was necessary. Five radiologists from three hospitals twice interpreted lumbar MR examination results in 53 patients with low back pain, with at least a 14-day interval between assessments. Radiologists were unaware of the clinical and demographic characteristics of the patients and of their colleagues' assessments. At the second assessment, they were unaware of the results of the first assessment. Reports on Modic changes, osteophytes, Schmorl nodes, diffuse defects, disk degeneration, annular tears (high-signal-intensity zones), disk contour, spondylolisthesis, and spinal stenosis were collected by using the Spanish version of the Nordic Modic Consensus Group classification. The kappa statistic was used to assess intra- and interobserver agreement for findings with a prevalence of 10% or greater and 90% or lower. kappa was categorized as almost perfect (0.81-1.00), substantial (0.61-0.80), moderate (0.41-0.60), fair (0.21-0.40), slight (0.00-0.20), or poor (<0.00).
Endplate erosions and spondylolisthesis were observed in less than 10% of images. Intraobserver reliability was almost perfect for spinal stenosis; substantial for Modic changes, Schmorl nodes, disk degeneration, annular tears, and disk contour; and moderate for osteophytes. Interobserver reliability was moderate for Modic changes, Schmorl nodes, disk degeneration, annular tears, and disk contour; fair for osteophytes; and poor for spinal stenosis.
In conditions close to those of clinical practice, there was only moderate interobserver agreement in the reporting of findings at 1.5-T lumbar MR imaging.
http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.09090706/-/DC1.
在社区环境下评估腰椎 1.5T 磁共振成像（MR）的解读的观察者内和观察者间一致性。
本研究设计经 Ramón y Cajal 医院机构审查委员会批准。根据西班牙法律，对于此类研究，无需患者同意。3 家医院的 5 名放射科医生在至少间隔 14 天的时间内两次解读 53 例腰痛患者的腰椎 MR 检查结果。放射科医生不知道患者的临床和人口统计学特征，也不知道其同事的评估结果。在第二次评估时，他们不知道第一次评估的结果。使用西班牙版北欧 Modic 共识组分类，收集 Modic 改变、骨赘、Schmorl 结节、弥漫性缺损、椎间盘退变、环形撕裂（高信号区）、椎间盘轮廓、脊椎滑脱和椎管狭窄的报告。采用 Kappa 统计评估一致性，以评估患病率为 10%或更高和 90%或更低的发现的观察者内和观察者间一致性。Kappa 分类为极好（0.81-1.00）、显著（0.61-0.80）、中等（0.41-0.60）、适度（0.21-0.40）、轻度（0.00-0.20）或差（0.00）。
不到 10%的图像观察到终板侵蚀和脊椎滑脱。观察者内可靠性对于椎管狭窄为极好；对于 Modic 改变、Schmorl 结节、椎间盘退变、环形撕裂和椎间盘轮廓为显著；对于骨赘为中度。观察者间可靠性对于 Modic 改变、Schmorl 结节、椎间盘退变、环形撕裂和椎间盘轮廓为中度；对于骨赘为适度；对于椎管狭窄为差。
在接近临床实践的情况下，在 1.5T 腰椎 MR 成像的结果报告中，只有中度的观察者间一致性。
http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.09090706/-/DC1.
