Reliability and Agreement of Ultrasonographic Measures of the Ovarian Stroma: Impact of Methodology.
Reliability and Agreement of Ultrasonographic Measures of the Ovarian Stroma: Impact of Methodology.
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卵巢基质超声测量的可靠性和一致性：方法论的影响。
DOI：
10.1002/jum.15917
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发表时间：
2022-09
影响因子：
2.3
通讯作者：
Lujan, Marla E.
中科院分区：
文献类型：
--
作者：
Vanden Brink, Heidi;Nosrati, Avigdor;Ortiz-Flores, Andres E.;Tam, Ashley;Jarrett, Brittany Y.;Johnson, Lynn;Peppin, Andrew K.;Lujan, Marla E.
卵巢间质面积（SA）、间质与卵巢面积比（S/A）和回声增强（SEcho）增高已被提出作为多囊卵巢综合征的诊断指标。虽然存在几种评估基质的方法，但它们的可重复性尚未确定，这限制了临床应用。本研究旨在确定评估SA、S/A和SEcho的方法的相互信度和一致性。5名评分员在模拟实时（自由选择）和离线（固定帧）成像两种成像条件下，对30条卵巢线分别测试了3种获取SA和S/A的方法和1种获取SEcho的方法。对于SA，方法1从卵巢区域减去卵泡区域，方法2涉及勾画基质的外围，方法3代表一种混合方法，从勾画的基质中减去中心卵泡。世高的主观评分为3级。测定SA和S/A的类内相关系数（ICCs）和变异系数，测定SEcho的Fleiss kappa协议统计量（κ）。在自由选择和固定帧成像条件下，分别采用方法1 （ICC = 0.558和0.705）和方法2 （ICC = 0.522和0.230）或方法3 （ICC = 0.429和0.305）获得的SA量表间信度优于方法1 （ICC = 0.558和0.705）。不同方法间S/A的互信度也为中等至较差。评分者间的SEcho也不可靠（κ = <0.500）。超声评估卵巢间质与中等到较差的再现性相关。间接估计卵巢间质（方法1）可以优化，以产生可重复的方法，澄清间质的临床相关性。
Increased ovarian stromal area (SA), stromal-to-ovarian area ratio (S/A), and echogenicity (SEcho) on ultrasonography have been proposed as diagnostic markers for polycystic ovary syndrome. Although several methods to evaluate the stroma exist, their reproducibility has not been defined which limits clinical utility. This study aimed to determine the interrater reliability and agreement of methods to evaluate SA, S/A, and SEcho. Five raters tested 3 methods to obtain SA and S/A, and one to obtain SEcho on 30 ovarian cineloops under two imaging conditions, simulating real-time (free-choice) or offline (fixed-frame) imaging. For SA, Method 1 subtracted follicular area from the ovarian area, Method 2 involved outlining the periphery of the stroma, and Method 3 represented a hybrid approach in which central follicles were subtracted from the outlined stroma. SEcho was scored on a subjective 3-tiered scale. Intraclass correlation coefficients (ICCs) and the coefficient of variation were determined for SA and S/A, and Fleiss’ kappa agreement statistics (κ) were determined for SEcho. Interrater reliability of SA was superior using Method 1 (ICC = 0.558 and ICC = 0.705) versus Method 2 (ICC = 0.522 and ICC = 0.230) or Method 3 (ICC = 0.429 and ICC = 0.305) under free-choice and fixed-frame imaging conditions, respectively. Interrater reliability of S/A was also moderate to poor across methods. SEcho was also not reliably assessed across raters (κ = <0.500). Ultrasonographic assessments of the ovarian stroma were associated with moderate to poor reproducibility. Indirect estimates of the ovarian stroma (Method 1) could be optimized to yield a reproducible approach, clarifying the clinical relevance of the stroma.
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影响因子：
5.2
作者：
Franks S;Hardy K
通讯作者：
Hardy K
影响因子：
7.7
作者：
CYR, L;FRANCIS, K
通讯作者：
FRANCIS, K
影响因子：
6.7
作者：
Fulghesu, AM;Ciampelli, M;Lanzone, A
通讯作者：
Lanzone, A
影响因子：
4
作者：
Loverro, Giuseppe;De Pergola, Giovanni;Caringella, Anna Maria
通讯作者：
Caringella, Anna Maria
影响因子：
2.9
作者：
Atiomo, WU;Pearson, S;Dubbins, P
通讯作者：
Dubbins, P