De Maio Peter, White Lawrence M, Bleakney Robert, Menezes Ravi J, Theodoropoulos John
*Department of Medical Imaging, St. Michael's Hospital University of Toronto, Toronto, Ontario, Canada; †Department of Medical Imaging, Mount Sinai Hospital and the University Health Network, Toronto, Ontario, Canada; ‡Department of Medical Imaging, Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada; and §Department of Surgery, University of Toronto Orthopaedic Sport Medicine Program at Women's College Hospital, Division of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada.
Clin J Sport Med. 2014 Jul;24(4):308-14. doi: 10.1097/JSM.0000000000000005.
To evaluate the diagnostic performance of viewing magnetic resonance (MR) images on a handheld mobile device compared with a conventional radiology workstation for the diagnosis of intra-articular knee pathology.
Prospective comparison study.
Tertiary care center.
Fifty consecutive subjects who had MR imaging of the knee followed by knee arthroscopy were prospectively evaluated.
Two musculoskeletal radiologists independently reviewed each MR study using 2 different viewers: the OsiriX DICOM viewer software on an Apple iPhone 3GS device and eFilm Workstation software on a conventional picture archiving and communications system workstation.
Sensitivity and specificity of the iPhone and workstation interpretations was performed using knee arthroscopy as the reference standard. Intraobserver concordance and agreement between the iPhone and workstation interpretations were determined.
There was no statistically significant difference between the 2 devices for each paired comparison of diagnostic performance. For the iPhone interpretations, sensitivity ranged from 77% (13 of 17) for the lateral meniscus to 100% (17 of 17) for the anterior cruciate ligament. Specificity ranged from 74% (14 of 19) for cartilage to 100% (50 of 50) for the posterior cruciate ligament. There was a very high level of interobserver and intraobserver agreement between devices and readers. The iPhone reads took longer than the corresponding workstation reads, with a significant mean difference between the iPhone and workstation reads of 3.98 minutes (P < 0.001).
The diagnostic performance of interpreting MR images on a handheld mobile device for the assessment of intra-articular knee pathology is similar to that of a conventional radiology workstation, however, requires a longer viewing time.
Timely and accurate interpretation of complex medical images using mobile device solutions could result in new workflow efficiencies and ultimately improve patient care.
评估在手持移动设备上查看磁共振（MR）图像与在传统放射科工作站上查看图像相比，对膝关节内病变诊断的性能。
前瞻性比较研究。
三级医疗中心。
对连续50例接受膝关节MR成像并随后进行膝关节镜检查的受试者进行前瞻性评估。
两名肌肉骨骼放射科医生分别使用两种不同的查看器独立审查每项MR研究：苹果iPhone 3GS设备上的OsiriX DICOM查看器软件和传统图像存档与通信系统工作站上的eFilm Workstation软件。
以膝关节镜检查为参考标准，评估iPhone和工作站解读的敏感性和特异性。确定观察者内一致性以及iPhone和工作站解读之间的一致性。
在每项诊断性能的配对比较中，两种设备之间无统计学显著差异。对于iPhone的解读，外侧半月板的敏感性为77%（17例中的13例），前交叉韧带为百分之百（17例中的17例）。特异性从软骨的74%（19例中的14例）到后交叉韧带的百分之百（50例中的50例）。设备与阅片者之间观察者间和观察者内一致性水平非常高。iPhone阅片比相应的工作站阅片耗时更长，iPhone和工作站阅片的平均差异显著，为3.98分钟（P < 0.001）。
在手持移动设备上解读MR图像以评估膝关节内病变的诊断性能与传统放射科工作站相似，然而，需要更长的查看时间。
使用移动设备解决方案及时、准确地解读复杂医学图像可提高工作流程效率并最终改善患者护理。
