Beccati Francesca, Chalmers Heather J, Dante Sara, Lotto Eleonora, Pepe Marco
Dipartimento di Patologia, Diagnostica e Clinica Veterinaria, Università degli Studi di Perugia, Perugia, Italy.
Vet Radiol Ultrasound. 2013 Mar-Apr;54(2):176-84. doi: 10.1111/vru.12004. Epub 2012 Dec 26.
Osteochondrosis lesions commonly occur on the femoral trochlear ridges in horses and radiography and ultrasonography are routinely used to diagnose these lesions. However, poor correlation has been found between radiographic and arthroscopic findings of affected trochlear ridges. Interobserver agreement for ultrasonographic diagnoses and correlation between ultrasonographic and arthroscopic findings have not been previously described. Objectives of this study were to describe diagnostic sensitivity and interobserver agreement of radiography and ultrasonography for detecting and grading osteochondrosis lesions of the equine trochlear ridges, using arthroscopy as the reference standard. Twenty-two horses were sampled. Two observers independently recorded radiographic and ultrasonographic findings without knowledge of arthroscopic findings. Imaging findings were compared between observers and with arthroscopic findings. Agreement between observers was moderate to excellent (κ 0.48-0.86) for detecting lesions using radiography and good to excellent (κ 0.74-0.87) for grading lesions using radiography. Agreement between observers was good to excellent (κ 0.78-0.94) for detecting lesions using ultrasonography and very good to excellent (κ 0.86-0.93) for grading lesions using ultrasonography. Diagnostic sensitivity was 84-88% for radiography and 100% for ultrasonography. Diagnostic specificity was 89-100% for radiography and 60-82% for ultrasonography. Agreement between radiography and arthroscopy was good (κ 0.64-0.78). Agreement between ultrasonography and arthroscopy was very good to excellent (κ 0.81-0.87). Findings from this study support ultrasound as a preferred method for predicting presence and severity of osteochondrosis lesions involving the femoral trochlear ridges in horses.
骨软骨病损常见于马的股骨滑车嵴，X线摄影和超声检查常用于诊断这些病损。然而，已发现受影响滑车嵴的X线摄影和关节镜检查结果之间相关性较差。超声诊断的观察者间一致性以及超声检查和关节镜检查结果之间的相关性此前尚未见报道。本研究的目的是，以关节镜检查作为参考标准，描述X线摄影和超声检查对检测和分级马滑车嵴骨软骨病损的诊断敏感性和观察者间一致性。选取了22匹马。两名观察者在不知晓关节镜检查结果的情况下独立记录X线摄影和超声检查结果。比较了观察者之间的影像学检查结果以及与关节镜检查结果。对于使用X线摄影检测病损，观察者间一致性为中等至优秀（κ值0.48 - 0.86），对于使用X线摄影对病损进行分级，一致性为良好至优秀（κ值0.74 - 0.87）。对于使用超声检查检测病损，观察者间一致性为良好至优秀（κ值0.78 - 0.94），对于使用超声检查对病损进行分级，一致性为非常好至优秀（κ值0.86 - 0.93）。X线摄影的诊断敏感性为84% - 88%，超声检查为100%。X线摄影的诊断特异性为89% - 100%，超声检查为60% - 82%。X线摄影和关节镜检查之间的一致性良好（κ值0.64 - 0.78）。超声检查和关节镜检查之间的一致性为非常好至优秀（κ值0.81 - 0.87）。本研究结果支持将超声作为预测马股骨滑车嵴骨软骨病损的存在和严重程度的首选方法。
