R.E.N.A.L.肾计量评分的可重复性及观察者间一致性：聚焦于影像特征
Reproducibility and interobserver agreement of the R.E.N.A.L. nephrometry score: focus on imaging features.
作者信息
Vilaseca Richard Mast, Westphalen Antonio Carlos, Reis Henrique Ferreira, Zogbi Orlando Salomão, Silva Gyl Eanes, Dos Reis Rodolfo Borges, Muglia Valdair Francisco
机构信息
MD, Attending Radiologist, Radiology Department - Abdominal Imaging, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
MD, PhD, Associate Professor of Radiology, Radiology and Biomedical Engineering, University of California at San Francisco (UCSF), San Francisco, CA, USA.
出版信息
Radiol Bras. 2017 Jan-Feb;50(1):7-12. doi: 10.1590/0100-3984.2015.0174.
OBJECTIVE
To investigate the reproducibility and interobserver agreement for R.E.N.A.L. nephrometry scoring system.
MATERIALS AND METHODS
Two independent radiologists retrospectively analyzed 46 consecutive patients with renal masses, between 2008 and 2012, using the R.E.N.A.L. nephrometry score (RENAL-NS), which is based on the evaluation of five anatomical features of the tumor, as evaluated with computed tomography or magnetic resonance imaging: adius, xophytic/endophytic properties, earness to the collecting system, nterior or posterior descriptor, and ocation relative to the polar line. Tumor complexity was graded as low, intermediate, or high. The interobserver agreement was calculated for the total score and for the score for each parameter. Surgical excision of the tumors was used as the standard of reference.
RESULTS
The interobserver agreement for each of the RENAL-NS parameters, respectively, a hilar location, and the total score was 98%, 80%, 100%, 89%, 85%, 89%, and 93% of patients, corresponding to kappa values of 0.96, 0.65, 1.00, 0.75, 0.72, 0.78, and 0.88, respectively. The Nearness, Radius, and total score showed the best agreement. For the cases that were discordant in terms of the final score, no major implications in surgical planning were observed.
CONCLUSION
The RENAL-NS is a structured, useful system to assess the anatomical features of renal tumors. It is easily applicable and reproducible, even for less experienced radiologists.
目的
研究R.E.N.A.L.肾计量评分系统的可重复性及观察者间的一致性。
材料与方法
两名独立的放射科医生回顾性分析了2008年至2012年间连续的46例肾肿块患者，使用基于肿瘤五个解剖特征评估的R.E.N.A.L.肾计量评分（RENAL-NS），这些特征通过计算机断层扫描或磁共振成像进行评估：半径、外生/内生特性、与集合系统的接近程度、前后描述符以及相对于极线的位置。肿瘤复杂性分为低、中、高三个等级。计算观察者间在总分及各参数得分上的一致性。以肿瘤的手术切除作为参考标准。
结果
RENAL-NS各参数、肾门位置及总分的观察者间一致性分别为98%、80%、100%、89%、85%、89%和93%的患者，对应的kappa值分别为0.96、0.65、1.00、0.75、0.72、0.78和0.88。接近程度、半径及总分的一致性最佳。对于最终得分不一致的病例，在手术规划中未观察到重大影响。
结论
RENAL-NS是一个用于评估肾肿瘤解剖特征的结构化、有用的系统。即使对于经验较少的放射科医生，它也易于应用且具有可重复性。
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