Reliability of the Grading System for Fatty Degeneration of Rotator Cuff Muscles
Reliability of the Grading System for Fatty Degeneration of Rotator Cuff Muscles
复制标题
DOI：
10.1007/s11999-009-0818-6
复制
发表时间：
2010-06-01
影响因子：
4.2
通讯作者：
Oh, Chung Hee
中科院分区：
文献类型：
--
作者：
Oh, Joo Han;Kim, Sae Hoon;Oh, Chung Hee
肩袖肌肉的脂肪变性被认为是影响肩袖修复结果的最重要因素之一。然而，评分系统的可靠性并没有得到很好的验证。两名肌肉骨骼放射学专家和三名接受过肩关节奖学金培训的骨科医生审查了连续75例全层肩袖撕裂的每个肩袖肌肉的脂肪变性等级。根据Goutallier等人和Fuchs等人的系统，使用术前MR和术后CT关节造影评估脂肪变性等级。分析组间相关系数，以评估观察者间和观察者内的可靠性。对于使用Goutallier等系统的观察者间可靠性，MR关节造影（0.6-0.72）的组间相关系数高于CT关节造影（0.43-0.6），放射科医生（0.58-0.78）高于骨科医生（0.32-0.68）。Goutallier等人和Fuchs等人的系统之间没有差异。观察者内可靠性显示出相似的模式（0.26-0.81），但应考虑经验水平。虽然Goutallier等的系统在骨科中应用最广泛，但由于可靠性相对较低，因此应仔细解释报告的数据。证据等级：III级，诊断性研究。有关证据等级的完整描述，请参见作者指南。
Fatty degeneration of the rotator cuff muscles is considered one of the most important factors for the outcomes of cuff repair. However, the reliability of the grading system is not well validated. Two specialists in musculoskeletal radiology and three shoulder fellowship-trained orthopaedic surgeons reviewed the fatty degeneration grades of each cuff muscle of consecutive 75 full-thickness cuff tears. Fatty degeneration grades were assessed according to the systems of Goutallier et al. and Fuchs et al. using preoperative MR and postoperative CT arthrographies. The interclass correlation coefficient was analyzed to assess interobserver and intraobserver reliabilities. For interobserver reliability using the system of Goutallier et al. the interclass correlation coefficient was higher in MR arthrography (0.6-0.72) than in CT arthrography (0.43-0.6) and higher for radiologists (0.58-0.78) than for orthopaedic surgeons (0.32-0.68). There was no difference between the systems of Goutallier et al. and Fuchs et al. Intraobserver reliabilities showed a similar pattern (0.26-0.81), but the level of experience should be considered. Although the system of Goutallier et al. is most widely used in orthopaedics, reported data should be interpreted carefully because of the relatively low reliability.Level of Evidence: Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.