Copenhagen University Hospital at Glostrup, Copenhagen, Denmark.
Arthritis Care Res (Hoboken). 2014 May;66(5):741-8. doi: 10.1002/acr.22191.
To standardize ultrasound (US) in enthesitis.
An initial Delphi exercise was undertaken to define US-detected enthesitis and its core components. These definitions were subsequently tested on static images taken from spondyloarthritis patients in order to evaluate their reliability.
Excellent agreement (>80%) was obtained for including hypoechogenicity, increased thickness of the tendon insertion, calcifications, enthesophytes, erosions, and Doppler activity as core elementary lesions of US-detected enthesitis. US definitions were subsequently obtained for each elementary component. On static images, the intraobserver reliability showed a high degree of variability for the detection of elementary lesions, with kappa coefficients ranging from 0.13-1. The interobserver kappa values were variable, with the lowest kappa coefficient for enthesophytes (0.24) and the highest coefficient for Doppler activity at the enthesis (0.63).
This is the first consensus-based US definition of enthesitis and its elementary components and the first step performed to ensure a higher degree of homogeneity and comparability of results between studies and in daily clinical work.
使肌腱附着点炎的超声检查规范化。
最初进行了一项德尔菲法研究，以定义超声检测到的肌腱附着点炎及其核心成分。随后，将这些定义应用于来自脊柱关节炎患者的静态图像，以评估其可靠性。
将低回声、肌腱附着点增厚、钙化、骨赘、侵蚀和多普勒活动等作为超声检测到的肌腱附着点炎的核心基本病变，获得了>80%的优秀一致性。随后为每个基本成分获得了超声定义。在静态图像上，对基本病变的检测显示出观察者内高度的可变性，kappa 系数范围为 0.13-1。观察者间的 kappa 值各不相同，骨赘的 kappa 系数最低（0.24），附着点处的多普勒活动的系数最高（0.63）。
这是基于共识的肌腱附着点炎及其基本成分的超声定义的首次制定，也是在研究和日常临床工作中确保结果更高程度的一致性和可比性的第一步。
