Andersson Johanna K, Mucelli Raffaella Pozzi, Dueholm Margit, Fridsten Susanne, Grigoriadis Aristeidis, Guerriero Stefano, Leone Francesco Paolo, Valentin Lil, Van Den Bosch Thierry, Voulgarakis Nikolaos, Gemzell-Danielsson Kristina, Epstein Elisabeth
Department of Women's and Children's Health, Karolinska Institutet and Liljeholmens Gynecological Clinic, 11794 Stockholm, Sweden.
Department of Clinical Science, Intervention, and Technology (CLINTEC), Division of Radiology, Karolinska Institutet, 17177 Stockholm, Sweden.
Diagnostics (Basel). 2023 Jun 28;13(13):2193. doi: 10.3390/diagnostics13132193.
Our aim was to compare the inter-rater agreement about transvaginal ultrasonography (TVS) with magnetic resonance imaging (MRI) with regard to diagnosing adenomyosis and for assessing various predefined imaging features of adenomyosis, in the same set of women. The study cohort included 51 women, prospectively, consecutively recruited based on a clinical suspicion of adenomyosis. MRIs and TVS videoclips and 3D volumes were retrospectively assessed by four experienced radiologists and five experienced sonographers, respectively. Each rater subjectively evaluated the presence or absence of adenomyosis, as well as imaging features suggestive of adenomyosis. Fleiss kappa (κ) was used to reflect inter-rater agreement for categorical data, and the intraclass correlation coefficient (ICC) was used to reflect the reliability of quantitative data. Agreement between raters for diagnosing adenomyosis was higher for TVS than for MRI (κ = 0.42 vs. 0.28). MRI had a higher inter-rater agreement in assessing wall asymmetry, irregular junctional zone (JZ), and the presence of myometrial cysts, while TVU had a better agreement for assessing globular shape. MRI showed a moderate to good reliability for measuring the JZ (ICC = 0.57-0.82). For TVS, the JZ was unmeasurable in >50% of cases, and the remaining cases had low reliability (ICC = -0.31-0.08). We found that inter-rater agreement for diagnosing adenomyosis was higher for TVS than for MRI, despite the fact that MRI showed a higher inter-rater agreement in most specific features. Measurements of JZ in the coronal plane with 3D TVS were unreliable and thus unlikely to be useful for diagnosing adenomyosis.
我们的目的是比较同一组女性中，经阴道超声检查（TVS）与磁共振成像（MRI）在诊断子宫腺肌病以及评估子宫腺肌病各种预定义影像特征方面的评分者间一致性。研究队列包括51名女性，她们基于子宫腺肌病的临床疑似情况被前瞻性、连续招募。MRI以及TVS视频片段和三维容积分别由四名经验丰富的放射科医生和五名经验丰富的超声检查医师进行回顾性评估。每位评分者主观评估子宫腺肌病的有无以及提示子宫腺肌病的影像特征。Fleiss卡方（κ）用于反映分类数据的评分者间一致性，组内相关系数（ICC）用于反映定量数据的可靠性。TVS诊断子宫腺肌病时评分者间的一致性高于MRI（κ = 0.42对0.28）。MRI在评估肌壁不对称、交界区不规则（JZ）以及肌层囊肿的存在方面评分者间一致性更高，而TVS在评估球形方面一致性更好。MRI测量JZ显示出中度到良好的可靠性（ICC = 0.57 - 0.8）。对于TVS，超过50%的病例无法测量JZ，其余病例可靠性较低（ICC = -0.31 - 0.08）。我们发现，尽管MRI在大多数特定特征方面评分者间一致性更高，但TVS诊断子宫腺肌病时评分者间的一致性高于MRI。用三维TVS在冠状面测量JZ不可靠，因此不太可能用于诊断子宫腺肌病。
