Whole-organ magnetic resonance imaging score (WORMS) of the knee in osteoarthritis
Whole-organ magnetic resonance imaging score (WORMS) of the knee in osteoarthritis
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DOI：
10.1016/j.joca.2003.11.003
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发表时间：
2004-03-01
影响因子：
7
通讯作者：
Genant, HK
中科院分区：
文献类型：
--
作者：
Peterfy, CG;Guermazi, A;Genant, HK
目的：描述一种基于磁共振成像（MRI）结果的半定量评分方法，用于骨关节炎（OA）膝关节的多特征、全器官评估。确定该评分方法的观察者间一致性。检查评分方法中包含的特征之间的关联。方法：采用常规脉冲序列和临床1.5 T MRI系统对19例膝关节OA患者的19个膝关节进行MRI成像。图像由两名肌肉骨骼放射科医生使用包含14个特征的全器官MRI评分方法（WORMS）独立分析：关节软骨完整性、关节下骨髓异常、关节下囊肿、关节下骨磨损、边缘骨赘、内侧和外侧半月板完整性、前后交叉韧带完整性、内侧和外侧副韧带完整性、滑膜炎/积液、关节内松体、关节周围囊肿/滑囊炎。为每个特征确定类内相关系数（[CC），作为观察者间一致性的度量。不同特征的得分之间的关联用Spearman Rho表示。结果：所有膝关节MRI表现为结构异常。软骨丢失和骨赘是最常见的特征（分别为98%和92%）。最不常见的特征之一是韧带异常（8%）。观察者间对WORMS评分的一致性很高（大多数ICC值为>.80）。个体特征表现出很强的相互关联性。结论：本报告中描述的WORMS方法使用常规MR图像对OA患者的膝关节进行多特征、全器官评估，并且在受过训练的读者中显示出高度的观察者之间的一致性。该方法可用于OA的流行病学研究和临床试验。(C) 2003国际骨关节炎研究学会。Elsevier Ltd.出版。版权所有。
Objectives: To describe a semi-quantitative scoring method for multi-feature, whole-organ evaluation of the knee in osteoarthritis (OA) based on magnetic resonance imaging (MRI) findings. To determine the inter-observer agreement of this scoring method. To examine associations among the features included in the scoring method.Methods: Nineteen knees of 19 patients with knee OA were imaged with MRI using conventional pulse sequences and a clinical 1.5 T MRI system. Images were independently analyzed by two musculoskeletal radiologists using a whole-organ MRI scoring method (WORMS) that incorporated 14 features: articular cartilage integrity, subarticular bone marrow abnormality, subarticular cysts, subarticular bone attrition, marginal osteophytes, medial and lateral meniscal integrity, anterior and posterior cruciate ligament integrity, medial and lateral collateral ligament integrity, synovitis/effusion, intraarticular loose bodies, and periarticular cysts/bursitis. Intraclass correlation coefficients ([CC) were determined for each feature as a measure of inter-observer agreement. Associations among the scores for different features were expressed as Spearman Rho.Results: All knees showed structural abnormalities with MRI. Cartilage loss and osteophytes were the most prevalent features (98% and 92%, respectively). One of the least common features was ligament abnormality (8%). Inter-observer agreement for WORMS scores was high (most ICC values were >0.80). The individual features showed strong inter-associations.Conclusion: The WORMS method described in this report provides multi-feature, whole-organ assessment of the knee in OA using conventional MR images, and shows high inter-observer agreement among trained readers. This method may be useful in epidemiological studies and clinical trials of OA. (C) 2003 OsteoArthritis Research Society International. Published by Elsevier Ltd. All rights reserved.