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Categorization of acromial shape: interobserver variability with MR imaging and conventional radiography
T M Haygood1, C P Langlotz, J B Kneeland
1Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
AJR. American Journal of Roentgenology
|June 1, 1994
Summary
Interobserver agreement for acromion shape on magnetic resonance imaging (MRI) was poor, while moderate agreement was found with conventional radiographs. This suggests the interpretation system may be better suited for radiographs than MRI.
Area of Science:
- Orthopedics
- Radiology
- Medical Imaging
Background:
- The shape of the acromion is crucial for diagnosing shoulder pathologies.
- Standardized interpretation systems aim to improve diagnostic accuracy and consistency.
Purpose of the Study:
- To assess interobserver variability in interpreting acromion shape using sagittal oblique MRI and conventional radiographs.
- To compare the diagnostic utility of MRI versus radiographs for acromion shape classification.
Main Methods:
- Four reviewers independently graded acromion shape on 26 sets of sagittal oblique MRI and corresponding shoulder radiographs.
- Interobserver agreement was quantified using the kappa statistic.
- Univariate analysis included analysis of variance and the chi-squared test.
Main Results:
- The acromion was most frequently classified as curved.
- A significantly higher proportion of MRI scans (9%) were deemed nondiagnostic compared to radiographs (28%).
- Kappa values indicated poor agreement for MRI (0.23) and moderate agreement for radiographs (0.43).
Conclusions:
- Despite higher diagnostic rates for MRI, interobserver agreement was poor.
- Conventional radiographs demonstrated moderate interobserver agreement.
- The current acromion shape classification system may be more applicable to conventional radiographs than MRI.