Department of Rheumatology, Oslo University Hospital, Oslo, Norway
Department of Rheumatology, Oslo University Hospital, Oslo, Norway.
RMD Open. 2021 Apr;7(2). doi: 10.1136/rmdopen-2021-001581.
To develop an ultrasonographic image acquisition protocol and a joint-specific scoring system for synovitis with reference atlas in patients with juvenile idiopathic arthritis (JIA) and to assess the reliability of the system.
Seven rheumatologists with extensive ultrasound experience developed a scanning protocol and a semiquantitative joint-specific scoring system for B-mode (BM) synovitis for the elbow, wrist, metacarpophalangeal 2-3, proximal interphalangeal 2-3, hip, knee, ankle and metatarsophalangeal 2-3 joints. An ultrasonographic reference atlas for BM synovitis, divided in four age groups (2-4, 5-8, 9-12, 13-18 years), and power Doppler (PD) activity was then developed. Reliability was assessed for all joints on still images and in a live exercise including 10 patients with JIA, calculated by intraclass correlation coefficient (ICC) and weighted kappa.
A scanning protocol and scoring system for multiple joints with reference atlas composed of images with four different score levels for BM and PD were developed. Still image scoring for BM synovitis on joint level showed good to excellent intra-reader reliability (ICC/kappa ranges: 0.75-0.95/0.63-0.91) and moderate to excellent inter-reader reliability (ICC/kappa ranges: 0.89-0.99/0.50-0.91). Still image scoring for PD activity showed excellent intra-reader and inter-reader reliability (ICC/kappa: 0.96/0.91 and ICC/kappa: 0.97/0.80, respectively). In the live scoring, inter-reader reliability (ICC/kappa) was moderate to excellent for BM synovitis (0.94/0.51) and PD activity (0.91/0.60).
An ultrasonographic image acquisition protocol and joint-specific scoring system with reference atlas were developed and demonstrated moderate to excellent reliability for scoring of synovitis in patients with JIA. This can be a valuable tool in clinical practice and future research.
制定一个针对幼年特发性关节炎（JIA）患者的超声图像采集方案和关节特异性滑膜炎参考图谱评分系统，并评估该系统的可靠性。
7 名具有丰富超声经验的风湿病专家制定了一种 B 型（BM）滑膜炎的扫描方案和半定量关节特异性评分系统，用于肘部、腕部、掌指关节 2-3、近端指间关节 2-3、髋关节、膝关节、踝关节和跖趾关节 2-3 关节。然后开发了一个 BM 滑膜炎的超声参考图谱，分为四个年龄组（2-4 岁、5-8 岁、9-12 岁、13-18 岁）和能量多普勒（PD）活动。通过计算组内相关系数（ICC）和加权 kappa，对包括 10 名 JIA 患者的 10 个关节的静态图像和实时运动图像的所有关节进行了可靠性评估。
制定了一种多关节扫描方案和评分系统，包括一个参考图谱，图谱由 BM 和 PD 四个不同评分水平的图像组成。关节水平的 BM 滑膜炎的静态图像评分显示出良好到极好的读者内可靠性（ICC/kappa 范围：0.75-0.95/0.63-0.91）和中度到极好的读者间可靠性（ICC/kappa 范围：0.89-0.99/0.50-0.91）。PD 活动的静态图像评分显示出极好的读者内和读者间可靠性（ICC/kappa：0.96/0.91 和 ICC/kappa：0.97/0.80）。在实时评分中，BM 滑膜炎（ICC/kappa：0.94/0.51）和 PD 活动（ICC/kappa：0.91/0.60）的读者间可靠性为中度到极好。
制定了一种超声图像采集方案和关节特异性评分系统，并结合参考图谱，用于评估 JIA 患者的滑膜炎，具有中度到极好的可靠性。这可能是临床实践和未来研究中的一种有价值的工具。
