Department of Orthopaedic Surgery, University Hospital of Tübingen.
Faculty of Medicine, Julius-Maximilians University of Würzburg.
Magn Reson Med Sci. 2020 Aug 3;19(3):207-215. doi: 10.2463/mrms.mp.2019-0079. Epub 2019 Sep 24.
Numerous classification systems have been proposed to analyze lumbar spine MRI scans. When evaluating these systems, most studies draw their conclusions from measurements of experienced clinicians. The aim of this study was to evaluate the impact of specific measurement training on interobserver reliability in MRI classification of the lumbar spine.
Various measurement and classification systems were assessed for their interobserver reliability in 30 MRIs from patients with chronic lumbar back and sciatic pain. Two observers were experienced spine surgeons. The third observer was an inexperienced medical student who, prior to the study measurements, in addition to being given the detailed written instructions also given to the surgeons, obtained a list of 20 reference measurements in MRI scans from other patients to practice with.
Excellent agreement was observed between the medical student and the spine surgeon who had also created the reference measurements. Between the two spine surgeons, agreement was markedly lower in all systems investigated (e.g., antero-posterior spinal canal diameter intraclass correlation coefficient [ICC] [3.1] = 0.979 vs. ICC [3.1] = 0.857).
These data warrant the creation of publicly available standardised measurement examples of accepted classification systems to increase reliability of the interpretation of MR images.
已经提出了许多分类系统来分析腰椎 MRI 扫描。在评估这些系统时，大多数研究都是从经验丰富的临床医生的测量结果中得出结论。本研究旨在评估特定测量培训对腰椎 MRI 分类中观察者间可靠性的影响。
在 30 例慢性腰痛和坐骨神经痛患者的 MRI 中，评估了各种测量和分类系统的观察者间可靠性。两名观察者是经验丰富的脊柱外科医生。第三名观察者是一名缺乏经验的医学生，在进行研究测量之前，除了获得详细的书面说明外，还获得了其他患者的 20 个参考 MRI 扫描测量值列表，以便进行练习。
医学生和也创建了参考测量值的脊柱外科医生之间观察到极好的一致性。在所有调查的系统中，两名脊柱外科医生之间的一致性明显较低（例如，前后椎管直径的组内相关系数[ICC] [3.1] = 0.979 与 ICC [3.1] = 0.857）。
这些数据证明需要创建可公开获得的公认分类系统的标准化测量示例，以提高 MRI 图像解释的可靠性。
