本文選題：磁共振成像 + 抗肌萎縮蛋白病��； 參考：《放射學實踐》2016年03期

【摘要】：目的:比較3位閱片者肌肉脂化率主觀評分結果的一致性,分析主觀評分法與客觀評分法的相關性,評價抗肌萎縮蛋白病中肌肉脂肪浸潤主觀評分法的穩(wěn)定性及可靠性。方法:搜集本院2012年1月-2015年8月抗肌萎縮蛋白病患者194例,行雙下肢橫軸面T1WI及IDEAL-Quant序列掃描。在橫軸面T1WI圖像中,由3位不同閱片者分別對所有患者下肢肌肉脂肪浸潤程度進行兩次主觀盲法評分;在IDEAL-Quant脂肪圖中測量得出肌肉脂化率。利用kappa檢驗分析各位閱片者自身及不同閱片者之間主觀評分結果的一致性,使用spearman相關模型分析主觀評分與IDEALQuant序列脂化率定量結果的相關性。結果:在對所有大腿肌肉脂肪浸潤的主觀半定量評估中,三位閱片者兩次閱片評分結果自身比較Kappa值分別為0.75、0.54、0.55;三位閱片者之間閱片評分結果 Kappa值分別為0.54、0.23、0.22。主觀評分結果與客觀定量結果相關(r=0.60~0.92,P0.05)。但主觀評分估計的脂肪浸潤程度高于客觀定量結果。結論:主觀評分法的結果相對穩(wěn)定、可靠,但與臨床經驗有關;主觀評分法會高估肌肉脂肪浸潤程度。
[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.
【作者單位】： 北京大學第一醫(yī)院醫(yī)學影像科;北京大學第一醫(yī)院神經內科;
【分類號】：R445.2;R746

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