BLOKS 和 WORMS 评分系统比较。I 部分。评估膝关节 MRI 中软骨形态、半月板损伤和骨髓病变的方法的横断面比较：来自骨关节炎倡议的数据。
Comparison of BLOKS and WORMS scoring systems part I. Cross sectional comparison of methods to assess cartilage morphology, meniscal damage and bone marrow lesions on knee MRI: data from the osteoarthritis initiative.
机构信息
Department of Epidemiology & Biostatistics, University of California at San Francisco, San Francisco, CA 94107, USA.
出版信息
Osteoarthritis Cartilage. 2010 Nov;18(11):1393-401. doi: 10.1016/j.joca.2010.08.017. Epub 2010 Sep 16.
OBJECTIVE
To compare two semiquantitative scoring systems for assessing the prevalence and severity of morphologic cartilage lesions, meniscal damage and bone marrow lesions (BMLs) from Magnetic Resonance Imagings (MRIs) of knees with osteoarthritis (OA).
METHODS
From participants in the OA Initiative (OAI), a sample of 115 knees with radiographic OA at high risk of cartilage loss, were selected based on risk factors for progression. Knee MRIs were read separately using both Whole Organ MR Scoring (WORMS) and Boston-Leeds OA Knee Scoring (BLOKS), and a subset was fed back to readers for reliability. Baseline readings were used for comparison of the two methods for inter-reader reliability as well as agreement on presence/absence and severity of MRI features at both the compartment level and finer anatomical subregion levels.
RESULTS
Both methods had high inter-reader agreement for all features studied (kappa for WORMS 0.69-1.0 and for BLOKS 0.65-1.0). Although the methods agreed well on presence and severity of morphological cartilage lesions (inter-method kappas from 0.66 to 0.95), BLOKS was more sensitive for full thickness defects. The two methods gave equivalent results for extent (kappa 0.74-0.80) and number (Spearman's Rho=0.85) of BMLs, and little extra information was obtained using the more complex BLOKS BML scoring. Similar results were also obtained for the common types of meniscal damage and extrusion (inter-method kappa 0.85-0.94), but the inclusion in BLOKS of meniscal signal abnormality and uncommon types of tear may be an advantage if these prove clinically meaningful.
CONCLUSION
Both WORMS and BLOKS had high reliability. The two methods gave similar results in this sample for prevalence and severity of cartilage loss, BMLs and meniscal damage. Selecting between, or combining, the two methods should be based on factors such as reader effort, appropriateness for the goals of a study, and longitudinal performance.
目的
比较两种半定量评分系统，用于评估磁共振成像（MRI）膝关节骨关节炎（OA）患者的形态学软骨病变、半月板损伤和骨髓病变（BML）的患病率和严重程度。
方法
从 OA 倡议（OAI）的参与者中，选择了 115 个存在放射学 OA 的膝关节样本，这些膝关节有较高的软骨丢失风险，选择的依据是进展的危险因素。使用全器官 MR 评分（WORMS）和波士顿-利兹 OA 膝关节评分（BLOKS）分别对膝关节 MRI 进行单独阅读，并将一部分反馈给读者进行可靠性评估。基线读数用于比较两种方法在读者间的可靠性，以及在关节间和更精细的解剖亚区水平上 MRI 特征的存在/缺失和严重程度的一致性。
结果
两种方法对所有研究特征均具有较高的读者间一致性（WORMS 的κ值为 0.69-1.0，BLOKS 的κ值为 0.65-1.0）。虽然两种方法在形态学软骨病变的存在和严重程度上一致性较好（κ值为 0.66-0.95），但 BLOKS 对全层缺损更敏感。两种方法在 BML 的范围（κ值为 0.74-0.80）和数量（Spearman's Rho=0.85）上给出了等效的结果，使用更复杂的 BLOKS BML 评分并没有获得更多的信息。对于常见类型的半月板损伤和外突，也得到了类似的结果（κ值为 0.85-0.94），但如果这些发现具有临床意义，BLOKS 中包括半月板信号异常和不常见的撕裂类型可能是一个优势。
结论
WORMS 和 BLOKS 均具有较高的可靠性。在本样本中，两种方法在软骨丢失、BML 和半月板损伤的患病率和严重程度方面给出了相似的结果。在两种方法之间进行选择或组合，应基于读者的工作量、研究目标的适宜性以及纵向表现等因素。
Zotero 插件