Wang W, van Heerden J, Tacey M A, Gaillard F
From the Department of Radiology (W.W., F.G.)
Perth Radiological Clinic (J.v.H.), Subiaco, Western Australia, Australia.
AJNR Am J Neuroradiol. 2017 Jul;38(7):1323-1327. doi: 10.3174/ajnr.A5185. Epub 2017 May 4.
Multiple sclerosis monitoring is based on the detection of new lesions on brain MR imaging. Outside of study populations, MS imaging studies are reported by radiologists with varying expertise. The aim of this study was to investigate the accuracy of MS reporting performed by neuroradiologists (someone who had spent at least 1 year in neuroradiology subspecialty training) versus non-neuroradiologists.
Patients with ≥2 MS studies with 3T MR imaging that included a volumetric T2 FLAIR sequence performed between 2009 and 2011 inclusive were recruited into this study. The reports for these studies were analyzed for lesions detected, which were categorized as either progressed or stable. The results from a previous study using a semiautomated assistive software for lesion detection were used as the reference standard.
There were 5 neuroradiologists and 5 non-neuroradiologists who reported all studies. In total, 159 comparison pairs (ie, 318 studies) met the selection criteria. Of these, 96 (60.4%) were reported by a neuroradiologist. Neuroradiologists had higher sensitivity (82% versus 42%), higher negative predictive value (89% versus 64%), and lower false-negative rate (18% versus 58%) compared with non-neuroradiologists. Both groups had a 100% positive predictive value.
Neuroradiologists detect more new lesions than non-neuroradiologists in reading MR imaging for follow-up of MS. Assistive software that aids in the identification of new lesions has a beneficial effect for both neuroradiologists and non-neuroradiologists, though the effect is more profound in the non-neuroradiologist group.
多发性硬化症的监测基于脑部磁共振成像上新病灶的检测。在研究人群之外，多发性硬化症成像研究由专业水平各异的放射科医生报告。本研究的目的是调查神经放射科医生（接受过至少1年神经放射学亚专业培训的人员）与非神经放射科医生进行多发性硬化症报告的准确性。
纳入在2009年至2011年（含）期间进行过≥2次3T磁共振成像研究且包含容积性T2 FLAIR序列的多发性硬化症患者。分析这些研究报告中检测到的病灶，将其分类为进展性或稳定性病灶。将先前一项使用半自动辅助软件进行病灶检测的研究结果用作参考标准。
有5名神经放射科医生和5名非神经放射科医生报告了所有研究。总共有159对比较（即318项研究）符合选择标准。其中，96项（60.4%）由神经放射科医生报告。与非神经放射科医生相比，神经放射科医生具有更高的敏感性（82%对42%）、更高的阴性预测值（89%对64%）和更低的假阴性率（18%对58%）。两组的阳性预测值均为100%。
在阅读用于多发性硬化症随访的磁共振成像时，神经放射科医生比非神经放射科医生能检测到更多新病灶。有助于识别新病灶的辅助软件对神经放射科医生和非神经放射科医生均有有益影响，尽管在非神经放射科医生组中影响更为显著。
