肩袖疾病：磁共振成像诊断中的观察者间和观察者内差异

Rotator cuff disorders: interobserver and intraobserver variation in diagnosis with MR imaging.

作者信息

Robertson P L, Schweitzer M E, Mitchell D G, Schlesinger F, Epstein R E, Frieman B G, Fenlin J M

机构信息

Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107.

出版信息

Radiology. 1995 Mar;194(3):831-5. doi: 10.1148/radiology.194.3.7862988.

DOI:10.1148/radiology.194.3.7862988

PMID:7862988

Abstract

PURPOSE

To determine interobserver and intraobserver variation in the interpretation of magnetic resonance (MR) images in rotator cuff disorders.

MATERIALS AND METHODS

MR images of the shoulder in 97 patients were retrospectively reviewed twice, with a 3-week interval. Surgical findings indicated a full-thickness tear in 29 patients, grade 1 impingement in 19 (tendinitis), and grade 2 impingement (partial tear) in 26. The control population comprised 23 asymptomatic volunteers or patients.

RESULTS

All observers were accurate in the diagnosis of a full-thickness tear (89%-98%), with good intraobserver (kappa = 0.67-0.84) and interobserver agreement (kappa = 0.74-0.92). In diagnoses of tendinitis, partial tear, and normal cuff, there were wide ranges of sensitivity (13%-74%) and specificity (72%-93%), as well as poor interobserver (kappa = 0.12-0.60) and intraobserver agreement (kappa = 0.35-0.78).

CONCLUSION

Full-thickness tears of the rotator cuff can be accurately identified at MR imaging with little observer variation. Consistent differentiation of normal rotator cuff, tendinitis, and partial thickness tears is more difficult.

摘要

目的

确定在肩袖疾病的磁共振（MR）图像解读中观察者间和观察者内的差异。

材料与方法

回顾性分析97例患者肩部的MR图像，间隔3周进行两次分析。手术结果显示，29例患者为全层撕裂，19例为1级撞击（肌腱炎），26例为2级撞击（部分撕裂）。对照组包括23名无症状志愿者或患者。

结果

所有观察者对全层撕裂的诊断准确率均较高（89%-98%），观察者内一致性良好（kappa = 0.67-0.84），观察者间一致性也较好（kappa = 0.74-0.92）。在肌腱炎、部分撕裂和正常肩袖的诊断中，敏感性（13%-74%）和特异性（72%-93%）范围较广，观察者间一致性较差（kappa = 0.12-0.60），观察者内一致性也较差（kappa = 0.35-0.78）。