Cricket Australia, Melbourne, Australia.
Victoria House Medical Imaging, Melbourne, Australia.
Spine (Phila Pa 1976). 2020 Sep 15;45(18):E1166-E1171. doi: 10.1097/BRS.0000000000003277.
Comparative reliability and prospective validity.
First, to evaluate the reliability of four methods of assessing magnetic resonance imaging (MRI) bone marrow edema (BMO) of the posterior vertebral arch of the lumbar vertebrae of elite junior fast bowlers. Second, to evaluate the validity of the most reliable method for the early detection of lumbar bone stress injury.
MRI has demonstrated utility in identifying BMO in lumbar vertebrae. Methods to grade the severity of BMO may provide valuable insight to inform clinical management, particularly in elite athletes where detection of early-stage bone stress may prevent progression to more severe and costly bone stress injury.
Sixty-five male elite junior fast bowlers had repeat MRI scans during a cricket season. A subset of 19 bowlers' images were reassessed by experienced musculoskeletal radiologists to determine intra- and inter-rater reliability. All images were aligned with independent medical records of lower back symptoms and diagnosed bone stress injuries to establish the relationship of BMO and lumbar bone stress injury.
Clinical detection of abnormal BMO, whether the pars region of the vertebra was considered in its entirety or subdivided into regions, had fair-to-moderate inter-rater reliability, and fair-to-almost perfect intra-rater reliability. Measurement of BMO signal intensity using an imaging software tool had excellent intra-rater and inter-rater reliability (ICC = 0.848, 0.837). BMO signal intensity was positively associated with subsequent LBSI (P < 0.001), and differentiated between asymptomatic and symptomatic bowlers (P < 0.001).
Measurement of BMO signal intensity using an imaging software tool proved a reliable and valid measure of the severity of lumbar bone stress injury in elite junior fast bowlers.
比较可靠性和前瞻性有效性。
首先，评估四种评估腰椎后椎弓磁共振成像（MRI）骨髓水肿（BMO）的方法在精英青年快投手群体中的可靠性。其次，评估最可靠方法对早期检测腰椎骨应激损伤的有效性。
MRI 已证明在识别腰椎 BMO 方面具有实用性。分级 BMO 严重程度的方法可能为临床管理提供有价值的见解，特别是在精英运动员中，早期骨应激的检测可能防止进展为更严重和更昂贵的骨应激损伤。
在板球赛季期间，对 65 名男性精英青年快投手进行了重复 MRI 扫描。19 名投手的图像子集由经验丰富的肌肉骨骼放射科医生重新评估，以确定内部和外部评估者之间的可靠性。所有图像都与下背部症状和诊断为骨应激损伤的独立病历对齐，以确定 BMO 与腰椎骨应激损伤的关系。
临床检测异常 BMO，无论是整个椎板区域还是分为区域，都具有中等至中度的外部评估者之间的可靠性，以及中等至近乎完美的内部评估者之间的可靠性。使用成像软件工具测量 BMO 信号强度具有极好的内部和外部评估者之间的可靠性（ICC=0.848，0.837）。BMO 信号强度与随后的 LBSI 呈正相关（P<0.001），并区分无症状和有症状的投手（P<0.001）。
使用成像软件工具测量 BMO 信号强度是一种可靠且有效的方法，可用于评估精英青年快投手中腰椎骨应激损伤的严重程度。
2 级。
