慢性炎症性神经病中臂丛 MRI 的观察者间可靠性低。
Low interrater reliability of brachial plexus MRI in chronic inflammatory neuropathies.
机构信息
Department of Neurology and Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, The Netherlands.
Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
出版信息
Muscle Nerve. 2020 Jun;61(6):779-783. doi: 10.1002/mus.26821. Epub 2020 Feb 21.
INTRODUCTION
Magnetic resonance imaging of the brachial plexus shows nerve thickening in approximately half of the patients with chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN). The reliability of qualitative evaluation of brachial plexus MRI has not been studied previously.
METHODS
We performed an interrater study in a retrospective cohort of 19 patients with CIDP, 17 patients with MMN, and 14 controls. The objective was to assess interrater variability between radiologists by using a predefined scoring system that allowed the distinction of no, possible, or definite nerve thickening.
RESULTS
Raters agreed in 26 of 50 (52%) brachial plexus images; κ-coefficient was 0.30 (SE 0.08, 95% confidence interval 0.14-0.46, P < .0005).
DISCUSSION
Our results provide evidence that interrater reliability of qualitative evaluation of brachial plexus MRI is low. Objective criteria for abnormality are required to optimize the diagnostic value of MRI for inflammatory neuropathies.
简介
磁共振成像（MRI）显示，约半数慢性炎症性脱髓鞘性多发性神经病（CIDP）和多发运动神经病（MMN）患者的臂丛神经变粗。此前尚未研究过定性评估臂丛 MRI 的可靠性。
方法
我们对 19 例 CIDP 患者、17 例 MMN 患者和 14 例对照者进行了回顾性队列研究。目的是使用预先设定的评分系统评估放射科医生之间的评分者间变异性，该系统可区分无、可能或确定的神经增粗。
结果
50 个臂丛神经图像中，有 26 个（52%）得到了评分者的一致认可；κ 值为 0.30（SE 0.08，95%置信区间 0.14-0.46，P < 0.0005）。
讨论
我们的研究结果表明，定性评估臂丛 MRI 的评分者间可靠性较低。需要客观的异常标准来优化 MRI 对炎性神经病的诊断价值。
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