双重问题 - - 鉴定由于"显示骨干"研究的双重评级导致的评级不一致性
Philipp Näther1,2, Jan Felix Kersten3, Anja Schablon4
1BG Klinikum Bergmannstrost Halle (Saale) gGmbH, Halle (Saale), Germany.
Journal of occupational medicine and toxicology (London, England)
|September 16, 2025
概括
腰椎MRI的放射性评估显示,评级者之间存在显著的差异. 标准化参数和测量方法对于提高MRI读数在诊断磁盘退化中的可靠性至关重要.
科学领域:
- 放射学 放射学是一门学科.
- 整形外科 整形外科 整形外科
- 医疗成像医学成像
背景情况:
- 磁共振成像 (MRI) 是评估腰椎椎间盘退化的主要方法.
- 目前的MRI评估依赖于主观的解释,导致潜在的不一致性.
- 这项研究探讨了从独立的MRI报告中对相同的腰椎图像的放射性评估的变异性.
研究的目的:
- 调查同一腰椎的两个独立的MRI报告之间的放射性评估中的差异.
- 量化不同评级者评估的各种成像参数的同意和不同意见.
- 突出主观性对磁盘退化MRI研究结果可靠性的影响.
主要方法:
- 腰椎和椎脊柱的MRI扫描从基于人口的女性样本和医疗保健工作者小组中获得.
- 来自检查诊所的两名放射科医生独立评估每个MRI,使用十个标准 (三个连续,七个分类).
- 对于连续参数,使用偏差和分散值,对于分类参数,使用科恩的kappa来评估一致性.
主要成果:
- 对318名参与者的分析显示,评级者之间的MRI评估存在相当大的差异.
- 科恩对分类参数的kappa在0.04到0.57之间,表明对某些标准的同意程度较差至中等.
- 连续测量的百分比差异从8%到24%不等,直接与参数的主观性相关.
结论:
- 通过使用明确定义的参数和标准化的测量技术,在腰椎MRI读数中提高了Interrater可靠性.
- 需要进一步的研究来确定日常临床使用的实际评级尺度,以提高报告可靠性.
- 实施参考图像可以作为一种有价值的策略,以减轻MRI解释中的主观性.
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