Oo Win Min, Linklater James M, Bennell Kim L, Daniel Matthew S, Pryke Danielle, Wang Xia, Yu Shirley P, Deveza Leticia, Duong Vicky, Hunter David J
Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, NSW, Australia.
Department of Physical Medicine and Rehabilitation, Mandalay General Hospital, University of Medicine, Mandalay, Mandalay, Myanmar.
J Ultrasound Med. 2022 Jun;41(6):1559-1573. doi: 10.1002/jum.15840. Epub 2021 Sep 26.
To determine: 1) inter-rater reliability of quantitative measurements of ultrasound-detected synovitis, meniscal extrusion, and osteophytes; and 2) construct (convergent) validity via correlations and absolute agreements between ultrasound- and gold-standard magnetic resonance imaging (MRI)-outcomes in knee osteoarthritis.
Dynamic ultrasound images for supra-patellar synovitis, meniscal extrusion, and osteophytes were acquired and quantified by a physician operator, musculoskeletal ultrasonographer, and medical student independently. On the same day, 3T MRI images were acquired. Effusion-synovitis, meniscal extrusion, and osteophytes were quantified on sagittal or coronal proton-density-weighted fat-suppressed noncontrast TSE sequences, respectively. Intra-class correlation coefficients (ICCs), Pearson's correlations (r), and Bland-Altman plots were used to analyze inter-rater reliability, and correlations, and agreements between the two imaging modalities.
Eighty-nine participants [48 females (53.9%)] with mean (standard deviation) age of 61.5 ± 6.9 years were included. The inter-rater reliability was excellent for osteophytes (ICC range = 0.90-0.96), meniscal extrusion (ICC range = 0.90-0.93), and synovitis (ICC range = 0.86-0.88). The correlations between ultrasound pathologies and their MRI counterparts were very strong (ICC range = 0.85-0.98) except for lateral meniscal extrusion [0.66 (95% CI, 0.52-0.76)]. Bland-Altman plots showed 0.01, 0.05, 0.10, 0.53, and 0.60 mm larger size in ultrasound medial tibial and medial femoral osteophytes, medial meniscal extrusions, synovitis, and lateral meniscal extrusions with 95% limits of agreements [±0.39, ±0.44, ±0.85, ±0.70, and ±0.90 (SDs)] than MRI measures, respectively. The lines of equality were within 95% CI of the mean differences (bias) only for medial osteophytes and medial meniscal extrusion.
The quantitative assessment of synovitis, meniscal extrusion, and osteophytes generally showed excellent inter-rater reliability and strong correlations with MRI-based measurements. Absolute agreement was strong for medial tibiofemoral pathologies.
确定：1）超声检测滑膜炎、半月板挤出和骨赘定量测量的评分者间可靠性；2）通过膝关节骨关节炎中超声与金标准磁共振成像（MRI）结果之间的相关性和绝对一致性构建（收敛）效度。
由一名医生操作者、一名肌肉骨骼超声检查医师和一名医学生独立采集并量化髌上滑膜炎、半月板挤出和骨赘的动态超声图像。在同一天，采集3T MRI图像。分别在矢状面或冠状面质子密度加权脂肪抑制非对比TSE序列上对积液性滑膜炎、半月板挤出和骨赘进行量化。组内相关系数（ICC）、Pearson相关性（r）和Bland-Altman图用于分析评分者间可靠性、两种成像方式之间的相关性和一致性。
纳入89名参与者[48名女性（53.9%）]，平均（标准差）年龄为61.5±6.9岁。骨赘（ICC范围=0.90-0.96）、半月板挤出（ICC范围=0.90-0.93）和滑膜炎（ICC范围=0.86-0.88）的评分者间可靠性极佳。除外侧半月板挤出[0.66（95%CI，0.52-0.76）]外，超声病变与其MRI对应病变之间的相关性非常强（ICC范围=0.85-0.98）。Bland-Altman图显示，超声测量的胫骨内侧和股骨内侧骨赘、内侧半月板挤出、滑膜炎和外侧半月板挤出的大小分别比MRI测量大0.01、0.05、0.10、0.53和0.60mm，95%一致性界限[±0.39、±0.44、±0.85、±0.70和±0.90（标准差）]。仅内侧骨赘和内侧半月板挤出的均值差异（偏差）的95%CI内有等号线。
滑膜炎、半月板挤出和骨赘的定量评估通常显示出极佳的评分者间可靠性，且与基于MRI的测量有很强的相关性。胫股内侧病变的绝对一致性很强。
