Robertson P L, Schweitzer M E, Mitchell D G, Schlesinger F, Epstein R E, Frieman B G, Fenlin J M
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107.
Radiology. 1995 Mar;194(3):831-5. doi: 10.1148/radiology.194.3.7862988.
To determine interobserver and intraobserver variation in the interpretation of magnetic resonance (MR) images in rotator cuff disorders.
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.
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).
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.
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。
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。
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）。
肩袖全层撕裂在MR成像中能够被准确识别，观察者间差异较小。而对正常肩袖、肌腱炎和部分厚度撕裂进行一致的鉴别则更为困难。
