Interobserver and Intraobserver variability in the sonographic assessment of fatty liver
Interobserver and Intraobserver variability in the sonographic assessment of fatty liver
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DOI：
10.2214/ajr.07.2123
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发表时间：
2007-12-01
影响因子：
5
通讯作者：
Katsnelson, Ludmila
中科院分区：
文献类型：
--
作者：
Strauss, Simon;Gavish, Ella;Katsnelson, Ludmila
客观的。本研究的目的是评估脂肪肝的存在和严重程度的超声评估中观察者间和观察者内的变异性。材料和方法。我们回顾性评估了 168 名接受腹部超声检查的成年患者的静态图像。三位经验丰富的放射科医生将肝脏图像独立分级为正常、轻度脂肪变性、中度脂肪变性或重度脂肪变性。 1个月后，在相同条件下对同一组图像重复进行肝脏脂肪变性评估，并对初始读数不知情。采用加权kappa统计分析观察者间和观察者内的一致性，并计算一致性百分比。结果。观察者间和观察者内对脂肪肝存在的平均一致性率为 72% (kappa = 0.43) 和 76% (kappa = 0.54)。对于脂肪肝的严重程度，观察者对的初始读数具有 47-59% (kappa = 0.40-0.51) 观察者间一致性。二读的观察者间一致性为 59-64% (kappa = 0.43-0.54)。第一次和第二次读数的观察者对的平均一致率为 53% (kappa = 0.47) 和 62% (kappa = 0.50)。观察者内对脂肪肝严重程度的一致性范围为 55% 至 68% (kappa = 0.51-0.63)。结论。超声检查对脂肪肝的主观视觉评估具有显着的观察者差异。需要一种更客观的超声检查量化脂肪肝分级方法，该方法易于获得并适用于常规临床实践。
OBJECTIVE. The purpose of this study was to evaluate interobserver and intraobserver variability in the sonographic assessment of the presence and severity of fatty liver.MATERIALS AND METHODS. We retrospectively evaluated the static images of 168 adult patients who had undergone abdominal sonography. Three experienced radiologists independently graded the hepatic images as normal, mild steatosis, moderate steatosis, or severe steatosis. Assessment of liver steatosis was repeated on the same set of images 1 month later under the same conditions and blinded to the initial reading. Weighted kappa statistics were used to analyze interobserver and intraobserver agreement, and the agreement percentages were calculated.RESULTS. The mean interobserver and intraobserver agreement rates for the presence of fatty liver were 72% (kappa = 0.43) and 76% (kappa = 0.54). For severity of fatty liver, the initial reading for pairs of observers had 47-59% (kappa = 0.40-0.51) interobserver agreement. The interobserver agreement for the second reading was 59-64% (kappa = 0.43-0.54). The mean agreement rates for pairs of observers were 53% (kappa = 0.47) and 62% (kappa = 0.50) on the first and second readings. Intraobserver agreement for severity of fatty liver ranged from 55% to 68% (kappa = 0.51-0.63).CONCLUSION. Subjective visual assessment of fatty liver on sonography has substantial observer variability. There is a need for a more objective quantitative method of grading fatty liver on sonography that would be easily available and applicable in routine clinical practice.