J Sport Rehabil. 2020 May 29;29(7):1042-1046. doi: 10.1123/jsr.2019-0476. Print 2020 Sep 1.
Ultrasound imaging is a clinically feasible tool to assess femoral articular cartilage and may have utility in tracking early knee osteoarthritis development. Traditional assessment techniques focus on measurements at a single location, which can be challenging to adopt for novice raters.
To introduce a novel semiautomated ultrasound segmentation technique and determine the intrarater and interrater reliability of average regional femoral articular cartilage thickness and echo intensity of a novice and expert rater.
Descriptive observational study.
Orthopedic clinic.
Fifteen participants (mean [SD]; age 23.5 [4.6] y, height = 172.6 [9.3] cm, mass = 79.8 [15.7] kg) with a unilateral history of anterior cruciate ligament reconstruction participated.
None.
One rater captured anterior femoral cartilage images of the participants' contralateral knees using a transverse suprapatellar ultrasound assessment. The total femoral cartilage cross-sectional area of each image was segmented by a novice and expert rater. A novel custom program automatically separated the cartilage segmentations into medial, lateral, and intercondylar regions to determine the cross-sectional area and cartilage length. The average cartilage thickness in each region was calculated by dividing the cross-sectional area by the cartilage length. Echo intensity was calculated as the average gray-scale pixel value of each region. Two-way random effect intraclass correlations coefficient (ICC) for absolute agreement were used to determine the interrater reliability between a novice and expert rater, as well as the intrarater reliability of the novice rater.
The novice rater demonstrated excellent intrarater (ICC [2,k] range = .993-.997) and interrater (ICC [2,k] range = .944-.991) reliability with the expert rater of all femoral articular cartilage average thickness and echo intensity regions.
The novel semiautomated average cartilage thickness and echo-intensity assessment is efficient, systematic, and reliable between an expert and novice rater with minimal training.
超声成像是一种评估股骨关节软骨的临床可行工具，可能有助于跟踪早期膝骨关节炎的发展。传统的评估技术侧重于单点测量，这对于新手评估者来说具有一定挑战性。
引入一种新的半自动超声分割技术，并确定新手和专家评估者测量股骨关节软骨平均厚度和回声强度的组内和组间可靠性。
描述性观察研究。
矫形科诊所。
15 名参与者（平均[标准差]；年龄 23.5 [4.6]岁，身高= 172.6 [9.3]厘米，体重= 79.8 [15.7]千克），单侧前交叉韧带重建史。
无。
一名评估者使用髌上横向超声评估技术获取参与者对侧膝关节的前股骨软骨图像。新手和专家评估者分别对每个图像的整个股骨软骨横截面积进行分割。一个新的定制程序自动将软骨分割为内侧、外侧和髁间区域，以确定横截面积和软骨长度。每个区域的平均软骨厚度通过将横截面积除以软骨长度来计算。回声强度通过计算每个区域的平均灰度像素值来表示。使用双向随机效应组内相关系数（ICC）评估绝对一致性来确定新手和专家评估者之间的组间可靠性，以及新手评估者的组内可靠性。
新手评估者与专家评估者在所有股骨关节软骨平均厚度和回声强度区域的组内（ICC[2,k]范围=。993-.997）和组间（ICC[2,k]范围=。944-.991）可靠性均表现出优异的可靠性。
新型半自动平均软骨厚度和回声强度评估方法在经过最少培训后，在专家和新手评估者之间是高效、系统和可靠的。
