Division of Diagnostic Radiology, Rovereto Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy.
Department of Industrial Engineering, University of Trento, via delle Regole, 101, I-38123, Mattarello, Trento, Italy.
Eur Radiol. 2020 Jun;30(6):3226-3235. doi: 10.1007/s00330-019-06627-5. Epub 2020 Feb 13.
To assess the performance of a morphological evaluation, based on a clinically relevant magnetic resonance imaging (MRI) protocol, in scoring the severity of knee cartilage damage. Specifically, to evaluate the reproducibility, repeatability, and agreement of MRI evaluation with the gross pathology examination (GPE) of the tissue.
MRI of the knee was performed the day before surgery in 23 patients undergoing total knee arthroplasty. Osteochondral tissue resections were collected and chondral defects were scored by GPE according to a semi-quantitative scale. MR images were independently scored by four radiologists, who assessed the severity of chondral damage according to equivalent criteria. Inter- and intra-rater agreements of MRI evaluations were assessed. Correlation, precision, and accuracy metrics between MRI and GPE scores were calculated.
Moderate to substantial inter-rater agreement in scoring cartilage damage by MRI was found among radiologists. Intra-rater agreement was higher than 96%. A significant positive monotonic correlation between GPE and MRI scores was observed for all radiologists, although higher correlation values were obtained by radiologists with expertise in musculoskeletal radiology and/or longer experience. The accuracy of MRI scores displayed a spatial pattern, characterized by lesion overestimation in the lateral condyle and underestimation in the medial condyle with respect to GPE.
Evaluation of knee cartilage morphology by MRI is a reproducible and repeatable technique, which positively correlates with GPE. Clinical expertise in musculoskeletal radiology positively impacts the evaluation reliability. These findings may help to address limitations in MRI evaluation of knee chondral lesions, thus improving MRI assessment of knee cartilage.
• MRI evaluation of knee cartilage shows moderate to strong correlation with gross pathology examination. • MRI evaluation overestimates cartilage damage in the lateral condyle and underestimates it in the medial condyle. • Education and experience of the radiologist play a role in MRI evaluation of knee chondral lesions.
评估一种基于临床相关磁共振成像（MRI）方案的形态学评估在评分膝关节软骨损伤严重程度方面的性能。具体来说，评估 MRI 评估与组织大体病理检查（GPE）的重复性、可重复性和一致性。
23 例接受全膝关节置换术的患者在手术前一天进行膝关节 MRI 检查。采集骨软骨组织标本，根据半定量评分标准进行 GPE 评分。4 名放射科医生独立对 MR 图像进行评分，根据等效标准评估软骨损伤的严重程度。评估 MRI 评估的组内和组间一致性。计算 MRI 和 GPE 评分之间的相关性、精度和准确性指标。
放射科医生对 MRI 评分软骨损伤具有中度至高度的组间一致性。组内一致性高于 96%。所有放射科医生均观察到 GPE 和 MRI 评分之间存在显著正单调相关性，但具有肌肉骨骼放射学专业知识和/或更长经验的放射科医生获得了更高的相关性值。MRI 评分的准确性显示出空间模式，特征为外侧髁病变高估，内侧髁低估相对于 GPE。
通过 MRI 评估膝关节软骨形态是一种可重复和可重复的技术，与 GPE 呈正相关。在肌肉骨骼放射学方面的临床专业知识对评估可靠性有积极影响。这些发现可能有助于解决 MRI 评估膝关节软骨病变的局限性，从而改善膝关节软骨的 MRI 评估。
• MRI 评估膝关节软骨与大体病理检查具有中度至高度相关性。• MRI 评估高估了外侧髁的软骨损伤，低估了内侧髁的软骨损伤。• 放射科医生的教育和经验在膝关节软骨病变的 MRI 评估中发挥作用。
