Reproducibility of evaluation of the uterus by transvaginal sonography, hysterosonographic examination, hysteroscopy and magnetic resonance imaging
Reproducibility of evaluation of the uterus by transvaginal sonography, hysterosonographic examination, hysteroscopy and magnetic resonance imaging
复制标题
DOI：
10.1093/humrep/17.1.195
复制
发表时间：
2002-01-01
影响因子：
6.1
通讯作者：
Laursen, H
中科院分区：
文献类型：
--
作者：
Dueholm, M;Lundorf, E;Laursen, H
背景：目的是评价和比较磁共振成像（MRI）、经阴道超声检查（TVS）、宫腔镜检查（HSE）和宫腔镜检查（HY）的观察者间再现性。方法：对51例因良性疾病行子宫切除术的绝经前妇女进行MRI、TVS、HSE、HY的独立评价。结果：观察者间一致性（kappa）：排除宫腔异常：MRI 0.97, TVS 0.68, HSE 0.48, HY 0.63；粘膜下肌瘤：MRI 0.97, TVS 0.59, HSE 0.60, HY 0.67；息肉：MRI 0.49, TVS 0.48, HSE 0.35, HY 0.50；子宫肌瘤的鉴别：MRI 0.97, TVS 0.74；子宫腺肌症：MRI 0.73, TVS 0.38。观察组间肌瘤数目的平均差异为（绝对值）MRI 0.58, TVS 0.93。MRI对子宫腔异常、粘膜下肌瘤、肌瘤数量和子宫腺肌症的评估一致性显著高于其他任何技术，而TVS、HSE和HY的一致性一致。结论：只有在HY、TVS和HSE排除子宫腔良性异常时，观察者之间的分歧才达到相当大的水平。应采取策略，以减少常见妇科影像学技术的观察者变异，或较少依赖观察者的MRI技术可以得到青睐。
BACKGROUND: The aim was to evaluate and compare inter-observer reproducibility by magnetic resonance imaging (MRI), transvaginal ultrasonography (TVS), hysterosonographic examination (HSE) and hysteroscopy (HY). METHODS: Different observers consecutively evaluated MRI, TVS, HSE and HY independently in 51 pre-menopausal women, who underwent hysterectomy for benign diseases. RESULTS: Inter-observer agreement (kappa) was as follows: Exclusion of uterine cavity abnormalities: MRI 0.97, TVS 0.68, HSE 0.48 and HY 0.63; submucous myomas: MRI 0.97, TVS 0.59, HSE 0.60 and HY 0.67; polyps: MRI 0.49, TVS 0.48, HSE 0.35 and HY 0.50; identification of myometrial myomas: MRI 0.97, TVS 0.74; adenomyosis: MRI 0.73 and TVS 0.38. Mean difference between observers in number of observed myomas was (absolute values) MRI 0.58, TVS 0.93. Agreement on evaluation of abnormalities in the uterine cavity, submucous myomas, number of myomas and adenomyosis was significantly greater by MRI than by any of the other techniques, whereas agreement was in line by TVS, HSE and HY. CONCLUSIONS: Inter-observer disagreement reached substantial levels only for exclusion of uterine cavity benign abnormalities by HY, TVS and HSE. Strategies should be adopted to reduce observer variation of common gynaecological imaging techniques or the less observer-dependent MRI technique could be favoured.