在磁共振成像中发现的侧带的可靠性
Eric N Bowman1, Aaron Sciascia2, Michael T Freehill3
1Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Journal of shoulder and elbow surgery
|July 22, 2023
概括
这项研究评估了MRI可靠性,用于诊断棒球运动员的侧带 (UCL) 撕裂. 虽然MRI对和全厚撕裂是可靠的,但对部分厚撕裂和组织特征的MRI表现不佳.
科学领域:
- 整形外科手术 整形外科手术
- 放射学 放射学是一门学科.
- 运动医学 运动医学
背景情况:
- 侧带 (UCL) 撕裂在棒球运动员中很普遍.
- 磁共振成像 (MRI) 是诊断UCL损伤的标准,但其对特定病理特征的可靠性尚未确定.
- 这项研究旨在确定MRI在评估UCL特征中的可靠性.
研究的目的:
- 评估非对比性MRI在评估侧带 (UCL) 病理学的各种特征方面的评分器间可靠性.
- 为了确定特定的UCL撕裂特征,放射科医生之间具有高和低的诊断一致性.
主要方法:
- 三位外科医生检查了UCL的45个非对比MRI (15个正常,15个部分撕裂,15个完整撕裂).
- 评估的特征包括水,缩,化,撕裂厚度和位置 (近位,中位,远位).
- 观察者之间的可靠性是使用Fleiss' κ系数来计算的.
主要成果:
- 观察到中部和远部带胀 (κ=0.50,0.69) 和近端骨胀 (κ=0.48) 的高度一致性.
- 中部实质 (κ=0.55) 和远部全厚撕裂 (κ=0.63) 显示出比近端撕裂 (κ=0.29) 更高的一致性.
- 对于近接带胀 (κ=0.08),带加厚 (κ=-0.02至0.20),化 (κ=-0.04至0.10) 和大多数部分厚度撕裂的情况,发现了较低的一致性.
结论:
- 非对比的MRI显示出高的inter-rater可靠性,用于检测近接骨胀,中部/远部带胀,以及全厚UCL撕裂.
- 对于部分厚度撕裂 (除近接层) 和UCL组织特征如加厚和化,可靠性很差.
- 需要进一步的研究来改进对UCL组织特征的MRI评估.
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