Department of Rheumatology, ZGT, Locatie Twenteborg Ziekenhuis, Postbus 7600, 7600 SZ Almelo, The Netherlands.
J Rheumatol. 2011 Jun;38(6):1003-8. doi: 10.3899/jrheum.100906. Epub 2011 Mar 1.
In rheumatology, magnetic resonance imaging (MRI) is predominantly applied in the assessment and outcome measurement of rheumatoid arthritis (RA) in hands and wrists, leading to the development of the RAMRIS (RA-MRI-Scoring) system. It was initiated by the Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT). The RAMRIS system has not been applied widely in the measurement of feet. We investigated the interreader and intrareader agreement of the RAMRIS scoring system in the assessment of feet in RA.
Twenty-nine patients with RA who had radiological damage and/or arthritis underwent MRI. Two experienced readers independently read both complete sets. One reader read 6 random sets after the initial session, in order to assess the intrareader agreement. For evaluation of the intrareader and interreader reliability, quadratic-weighted κ scores were calculated per joint and lesion.
For the forefeet, interreader scores were excellent, ranging from 0.77 (bone edema) to 0.95 (bone erosion). Hindfoot interreader agreement scores were highest for erosion (0.90) and synovitis global score (0.88), but edema and synovial thickness agreement were also acceptable (0.83 and 0.86). Intrareader scores were on the whole slightly lower, but excellent.
Reliability (interreader and intrareader agreement) in the assessment of the rheumatoid foot according to the RAMRIS method is excellent.
在风湿病学中，磁共振成像（MRI）主要应用于手部和腕部类风湿关节炎（RA）的评估和疗效测量，由此产生了 RAMRIS（RA-MRI-评分）系统。该系统由类风湿关节炎临床试验中的结局测量（OMERACT）发起。RAMRIS 系统尚未广泛应用于足部的测量。我们研究了 RAMRIS 评分系统在 RA 足部评估中的读者间和读者内一致性。
29 例有放射学损伤和/或关节炎的 RA 患者接受了 MRI 检查。两名有经验的读者分别独立阅读了所有的两套影像。一名读者在初始检查后阅读了 6 组随机影像，以评估读者内一致性。为了评估读者内和读者间的可靠性，每个关节和病变的二次加权κ评分进行计算。
在前足部，读者间评分极好，范围为 0.77（骨水肿）至 0.95（骨侵蚀）。后足的读者间评分以侵蚀（0.90）和滑膜炎整体评分（0.88）最高，但水肿和滑膜增厚的评分也可接受（0.83 和 0.86）。读者内评分总体上略低，但仍为极好。
根据 RAMRIS 方法评估类风湿性足部的可靠性（读者间和读者内一致性）极好。
