肌肉脂化率主观评分法的稳定性与可靠性研究

发布时间：2018-06-21 01:55

本文选题：磁共振成像 + 抗肌萎缩蛋白病　；参考：《放射学实践》2016年03期

【摘要】：目的:比较3位阅片者肌肉脂化率主观评分结果的一致性,分析主观评分法与客观评分法的相关性,评价抗肌萎缩蛋白病中肌肉脂肪浸润主观评分法的稳定性及可靠性。方法:搜集本院2012年1月-2015年8月抗肌萎缩蛋白病患者194例,行双下肢横轴面T1WI及IDEAL-Quant序列扫描。在横轴面T1WI图像中,由3位不同阅片者分别对所有患者下肢肌肉脂肪浸润程度进行两次主观盲法评分;在IDEAL-Quant脂肪图中测量得出肌肉脂化率。利用kappa检验分析各位阅片者自身及不同阅片者之间主观评分结果的一致性,使用spearman相关模型分析主观评分与IDEALQuant序列脂化率定量结果的相关性。结果:在对所有大腿肌肉脂肪浸润的主观半定量评估中,三位阅片者两次阅片评分结果自身比较Kappa值分别为0.75、0.54、0.55;三位阅片者之间阅片评分结果 Kappa值分别为0.54、0.23、0.22。主观评分结果与客观定量结果相关(r=0.60~0.92,P0.05)。但主观评分估计的脂肪浸润程度高于客观定量结果。结论:主观评分法的结果相对稳定、可靠,但与临床经验有关;主观评分法会高估肌肉脂肪浸润程度。
[Abstract]:Objective: to evaluate the stability and reliability of subjective scoring method for muscle fat infiltration in anti-muscular dystrophin disease by comparing the consistency of the subjective score of muscle fat rate in 3 film readers, analyzing the correlation between subjective scoring method and objective scoring method and evaluating the stability and reliability of the subjective scoring method for muscle fat infiltration in patients with anti-muscular dystrophin disease. Methods: 194 patients with anti-muscular dystrophy from January 2012 to August 2015 were examined with T1WI and IDEAL-Quant sequences. In the axial T1WI images, the degree of muscle fat infiltration in lower extremities was evaluated twice by three different film readers, and the muscle fatlization rate was measured in IDEAL-Quant fat map. Kappa test was used to analyze the consistency of subjective score between the readers themselves and different readers, and the spearman correlation model was used to analyze the correlation between the subjective score and the quantitative results of ideal Quant sequence fatlization rate. Results: in the subjective semi-quantitative evaluation of fat infiltration in all thigh muscles, the Kappa scores of the three film readers were 0.75 and 0.55, respectively, and the Kappa values of the three film readers were 0.540.230.22. The subjective score was correlated with the objective quantitative results. But the degree of fat infiltration estimated by subjective score was higher than that of objective quantitative results. Conclusion: the results of subjective scoring method are relatively stable and reliable, but related to clinical experience, and subjective scoring method can overestimate the degree of muscle fat infiltration.
【作者单位】：北京大学第一医院医学影像科;北京大学第一医院神经内科;
【分类号】：R445.2;R746

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