Overtime reliability of medial temporal lobe atrophy rating in a clinical setting
Overtime reliability of medial temporal lobe atrophy rating in a clinical setting
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DOI：
10.1258/ar.2012.110552
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发表时间：
2012-04-01
期刊：
影响因子：
1.3
通讯作者：
Axeisson, Rimma
中科院分区：
文献类型：
--
作者：
Cavallin, Lena;Loken, Kirsti;Axeisson, Rimma
背景：内侧颞叶萎缩（MTA）是阿尔茨海默病（AD）患者的第一个磁共振成像（MRI）体征之一，并被用作疾病进展的衡量标准。MTA的目测评价很容易实现，但MTA评分随时间的可靠性尚未得到研究。目的：研究如果两名放射科医生在一年内对相同的MRI扫描进行六次评分，MTA评分会发生什么变化。材料与方法：本研究纳入100例门诊患者。根据当地临床标准，所有患者均按照老年患者的方案和顺序进行MRI检查。一名神经放射科医生和一名普通放射科医生相互独立地对MTA进行了六次回顾性视觉评估，使用相同的扫描，为期一年。结果：神经放射科医师的kappa为0.65 ~ 0.84，普通放射科医师的kappa为0.38 ~ 0.74。两名研究者的加权kappa （w kappa）值几乎完全一致（w kappa 0.83-0.94）。评估间信度表现出中等到中等的一致性，kappa值从0.29到0.48不等，加权kappa值从0.72到0.84不等。两位研究者的评分有统计学上的显著差异。结论：当由经验丰富的研究者进行时，随时间重复的MTA视觉评估具有高度的可重复性。当评估很少执行时，再现性下降。当两个调查人员不一起工作时，比较的信度很低。
Background: Medial temporal lobe atrophy (MTA) is one of the first magnetic resonance imaging (MRI) signs in patients with Alzheimer's disease (AD) and used as a measure of disease progression. Visual assessment of MTA is easy to perform but the reliability of MTA rating over time has not been studied.Purpose: To investigate what happens to the MTA rating scores if two radiologists rate the same MRI scans six times over a period of 1 year.Material and Methods: One hundred outpatients were included in this study. All patients underwent MRI with a protocol and sequences used for geriatric patients, according to local clinical standards. One neuroradiologist and one general radiologist independently of each other performed retrospective visual assessments of MTA six times, using the same scans, over a period of 1 year.Results: Intra-rater kappa varied between kappa 0.65 and 0.84 for the neuroradiologist and kappa 0.38 and 0.74 for the general radiologist. Intra-rater weighted kappa (w kappa) values showed almost perfect agreement for both investigators (w kappa 0.83-0.94). Inter-rater reliability showed fair to moderate agreement, with the kappa value varying from kappa 0.29 to 0.48 and weighted kappa values ranging from w kappa 0.72 to 0.84. There was a statistically significant difference in rating between the two investigators.Conclusion: Visual assessment of MTA repeated over time has a high grade of reproducibility when performed by an experienced investigator. The reproducibility drops when assessment is rarely performed. Inter-rater reliability is low when two investigators not working together are compared.