Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Complutense University, and Hospital Universitario Severo Ochoa, Madrid, Spain.
Ann Rheum Dis. 2013 Aug;72(8):1328-34. doi: 10.1136/annrheumdis-2012-202092. Epub 2012 Sep 14.
To produce consensus-based scoring systems for ultrasound (US) tenosynovitis and to assess the intraobserver and interobserver reliability of these scoring systems in rheumatoid arthritis (RA).
We undertook a Delphi process on US-defined tenosynovitis and US scoring system of tenosynovitis in RA among 35 rheumatologists, experts in musculoskeletal US (MSUS), from 16 countries. Then, we assessed the intraobserver and interobserver reliability of US in scoring tenosynovitis on B-mode and with a power Doppler (PD) technique. Ten patients with RA with symptoms in the hands or feet were recruited. Ten rheumatologists expert in MSUS blindly, independently and consecutively scored for tenosynovitis in B-mode and PD mode three wrist extensor compartments, two finger flexor tendons and two ankle tendons of each patient in two rounds in a blinded fashion. Intraobserver reliability was assessed by Cohen's κ. Interobserver reliability was assessed by Light's κ. Weighted κ coefficients with absolute weighting were computed for B-mode and PD signal.
Four-grade semiquantitative scoring systems were agreed upon for scoring tenosynovitis in B-mode and for scoring pathological peritendinous Doppler signal within the synovial sheath. The intraobserver reliability for tenosynovitis scoring on B-mode and PD mode was good (κ value 0.72 for B-mode; κ value 0.78 for PD mode). Interobserver reliability assessment showed good κ values for PD tenosynovitis scoring (first round, 0.64; second round, 0.65) and moderate κ values for B-mode tenosynovitis scoring (first round, 0.47; second round, 0.45).
US appears to be a reproducible tool for evaluating and monitoring tenosynovitis in RA.
制定基于共识的超声（US）腱鞘炎评分系统，并评估这些评分系统在类风湿关节炎（RA）中观察者内和观察者间的可靠性。
我们在来自 16 个国家的 35 名风湿病学家、肌肉骨骼超声（MSUS）专家中进行了关于 US 定义的腱鞘炎和 RA 中 US 腱鞘炎评分系统的 Delphi 流程。然后，我们评估了 B 模式和功率多普勒（PD）技术下 US 评估腱鞘炎的观察者内和观察者间可靠性。招募了 10 名手部或足部有症状的 RA 患者。10 名 MSUS 专家在两轮盲法中，独立、连续地对每位患者的三个腕伸肌间隙、两个手指屈肌腱和两个踝关节肌腱的 B 模式和 PD 模式进行腱鞘炎评分。观察者内可靠性通过 Cohen's κ 评估。观察者间可靠性通过 Light's κ 评估。对 B 模式和 PD 信号进行了绝对权重加权 κ 系数计算。
我们达成了用于 B 模式下腱鞘炎评分和滑膜内病理性肌腱周围多普勒信号评分的四级半定量评分系统。B 模式和 PD 模式下腱鞘炎评分的观察者内可靠性良好（B 模式 κ 值为 0.72；PD 模式 κ 值为 0.78）。观察者间可靠性评估显示，PD 腱鞘炎评分的 κ 值较好（第一轮为 0.64，第二轮为 0.65），B 模式腱鞘炎评分的 κ 值为中等（第一轮为 0.47，第二轮为 0.45）。
US 似乎是一种可重复的工具，可用于评估和监测 RA 中的腱鞘炎。
