The MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) 2.0 Knee Score and Atlas.
The MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) 2.0 Knee Score and Atlas.
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DOI：
10.1177/1947603519865308
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发表时间：
2021-12
期刊：
影响因子：
2.8
通讯作者：
Trattnig S
中科院分区：
文献类型：
--
作者：
Schreiner MM;Raudner M;Marlovits S;Bohndorf K;Weber M;Zalaudek M;Röhrich S;Szomolanyi P;Filardo G;Windhager R;Trattnig S
自首次引入MOCART（软骨修复组织的磁共振观察）评分以来，在软骨缺损的手术治疗选择以及此类缺损的磁共振成像（MRI）方面取得了重大进展。因此，本研究的目的是引入MOCART 2.0膝关节评分-在原始MOCART评分基础上进行增量更新-并纳入该进展。软骨缺损填充的体积现在以25%的增量进行评估，高达150%的肥大填充获得与完全修复相同的评分。整合现在仅评估与邻近天然软骨的整合，并且根据软骨修复长度而不是深度评估表面不规则的严重程度。修复组织的信号强度区分正常信号、轻微异常或严重异常信号改变。删除了对变量“软骨下椎板”、“粘连”和“滑膜炎”的评估，并将这些点重新分配给新变量“骨缺损或骨过度生长”。变量“软骨下骨”被重命名为“软骨下改变”，并评估轻微和严重水肿样骨髓信号，以及软骨下囊肿或骨坏死样信号。总体而言，可达到0 - 100分的MOCART 2.0膝关节评分。4名独立阅片人（2名专家阅片人和2名经验有限的放射科住院医师）评估了24名患者的3 T MRI检查，这些患者使用新的MOCART 2.0膝关节评分进行了股骨软骨缺损的软骨修复。其中一位专家和两位经验不足的读者进行了两次阅读，间隔四周。对于没有经验的读片员，第一次阅读仅基于评价表。对于第二次阅读，使用新引入的图谱作为额外参考。使用组内相关系数（ICC）和加权Kappa统计评估评估者内和评估者间的可靠性。根据Koo和Li解释ICC;根据Landis和Koch标准解释加权Kappa统计。专家阅片者的总体内信度（ICC = 0.88，P < 0.001）和评分者间信度（ICC = 0.84，P < 0.001）接近完美。根据MOCART 2.0膝关节评分的评估表，无经验阅片者的总体评分者间可靠性较差（ICC = 0.34，P < 0.019），使用图谱后改善至中度（ICC = 0.59，P = 0.001）。更新了MOCART 2.0膝关节评分，以解释过去十年的变化，并在专家阅片员中证明了几乎完美的评定者间和评定者内可靠性。在没有经验的读者中，使用图集可以提高评价者之间的可靠性，从而增加研究结果的可比性。
Since the first introduction of the MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) score, significant progress has been made with regard to surgical treatment options for cartilage defects, as well as magnetic resonance imaging (MRI) of such defects. Thus, the aim of this study was to introduce the MOCART 2.0 knee score — an incremental update on the original MOCART score — that incorporates this progression. The volume of cartilage defect filling is now assessed in 25% increments, with hypertrophic filling of up to 150% receiving the same scoring as complete repair. Integration now assesses only the integration to neighboring native cartilage, and the severity of surface irregularities is assessed in reference to cartilage repair length rather than depth. The signal intensity of the repair tissue differentiates normal signal, minor abnormal, or severely abnormal signal alterations. The assessment of the variables “subchondral lamina,” “adhesions,” and “synovitis” was removed and the points were reallocated to the new variable “bony defect or bony overgrowth.” The variable “subchondral bone” was renamed to “subchondral changes” and assesses minor and severe edema-like marrow signal, as well as subchondral cysts or osteonecrosis-like signal. Overall, a MOCART 2.0 knee score ranging from 0 to 100 points may be reached. Four independent readers (two expert readers and two radiology residents with limited experience) assessed the 3 T MRI examinations of 24 patients, who had undergone cartilage repair of a femoral cartilage defect using the new MOCART 2.0 knee score. One of the expert readers and both inexperienced readers performed two readings, separated by a four-week interval. For the inexperienced readers, the first reading was based on the evaluation sheet only. For the second reading, a newly introduced atlas was used as an additional reference. Intrarater and interrater reliability was assessed using intraclass correlation coefficients (ICCs) and weighted kappa statistics. ICCs were interpreted according to Koo and Li; weighted kappa statistics were interpreted according to the criteria of Landis and Koch. The overall intrarater (ICC = 0.88, P < 0.001) as well as the interrater (ICC = 0.84, P < 0.001) reliability of the expert readers was almost perfect. Based on the evaluation sheet of the MOCART 2.0 knee score, the overall interrater reliability of the inexperienced readers was poor (ICC = 0.34, P < 0.019) and improved to moderate (ICC = 0.59, P = 0.001) with the use of the atlas. The MOCART 2.0 knee score was updated to account for changes in the past decade and demonstrates almost perfect interrater and intrarater reliability in expert readers. In inexperienced readers, use of the atlas may improve interrater reliability and, thus, increase the comparability of results across studies.
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DOI：
10.1016/j.injury.2008.01.043
发表时间：
2008-04-01
影响因子：
2.5
作者：
Marlovits, Stefan;Mamisch, Tallal Charles;Trattnig, Siegfried
通讯作者：
Trattnig, Siegfried
影响因子：
4.8
作者：
Farr, Jack;Gracitelli, Guilherme C.;Gomoll, Andreas H.
通讯作者：
Gomoll, Andreas H.
影响因子：
2.7
作者：
Brix, Martin;Kaipel, Martin;Trattnig, Siegfried
通讯作者：
Trattnig, Siegfried
影响因子：
2.7
作者：
Kubosch, Eva Johanna;Erdle, Benjamin;Niemeyer, Philipp
通讯作者：
Niemeyer, Philipp
影响因子：
4.8
作者：
Cole, Brian J.;Farr, Jack;De Deyne, Patrick G.
通讯作者：
De Deyne, Patrick G.