Identifying enthesitis in the sacroiliac joints in patients with axial spondyloarthritis by readers of varying experience: impact of the learning progress.

IF 2.1 Q3 RHEUMATOLOGY BMC Rheumatology Pub Date : 2024-08-21 DOI:10.1186/s41927-024-00397-4
Dong Liu, Jiaoshi Zhao, Churong Lin, Budian Liu, Jinwei Li, Yuxuan Zhang, Ou Jin, Jieruo Gu
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Abstract

Background: This study aimed to investigate the accuracy of identifying enthesitis along with other inflammatory lesions and structural lesions on the MRI of the sacroiliac joints (SIJ) by readers of varying experience and how training sessions and workshops could help improve the accuracy.

Methods: A total of 224 patients with clinical diagnosis of axial spondyloarthritis who underwent SIJ MRI examinations were retrospectively included in this study. Three readers with 5 years, 3 years and 1 year of experience in musculoskeletal imaging were invited to review the SIJ MRI images independently, while the imaging reports of a senior radiologist (> 10 years' experience) were used as reference. After the first round of image review, a training session and a workshop on the imaging of SIJ in spondyloarthritis were held and the three readers were asked to review the images in the second round. We calculated the accuracy of identifying inflammatory and structural lesions of the three readers as well as the intra-reader agreement.

Results: Enthesitis could be observed in 52.23% of the axial spondyloarthritis patients, while 81.58% of the patients with enthesitis were accompanied with bone marrow edema. All the three readers showed better accuracy at identifying structural lesions than inflammatory lesions. In the first round of image review, the three readers only correctly identified 15.07%, 2.94% and 0.74% of the enthesitis sites. After the training session and workshop, the accuracy rose to 61.03%, 39.34% and 20.22%. The intra-reader agreement of enthesitis calculated as Cohen's kappa was 0.23, 0.034 and 0.014, respectively.

Conclusion: Readers with less experience in musculoskeletal imaging showed lower accuracy of identifying inflammatory lesions, notably enthesitis. Training sessions and workshops could help improve the diagnostic accuracy of the junior readers.

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不同经验的读者识别轴性脊柱关节炎患者骶髂关节内的关节炎:学习进步的影响。
背景:本研究旨在探讨不同经验的读者在骶髂关节(SIJ)MRI检查中识别粘连炎及其他炎症病变和结构性病变的准确性,以及培训课程和研讨会如何帮助提高准确性:本研究回顾性地纳入了224例接受骶髂关节MRI检查的临床诊断为轴性脊柱关节炎的患者。研究邀请了三位分别有 5 年、3 年和 1 年肌肉骨骼成像经验的读者独立审阅 SIJ MRI 图像,同时参考一位资深放射科医生(10 年以上经验)的成像报告。第一轮图像审查结束后,我们举办了脊柱关节炎 SIJ 影像培训会和研讨会,并要求三位阅片人员进行第二轮图像审查。我们计算了三位阅片员识别炎症和结构性病变的准确性以及阅片员之间的一致性:结果:52.23%的轴性脊柱关节炎患者可观察到关节内膜炎,81.58%的关节内膜炎患者伴有骨髓水肿。三位阅片师对结构性病变的识别准确率均高于炎症性病变。在第一轮图像审查中,三位阅片员分别只正确识别了 15.07%、2.94% 和 0.74% 的关节炎部位。经过培训和研讨会后,准确率分别上升到 61.03%、39.34% 和 20.22%。以 Cohen's kappa 计算的阅读者内部对关节内粘连的一致性分别为 0.23、0.034 和 0.014:结论:肌肉骨骼成像经验较少的读者识别炎症病变(尤其是腱鞘炎)的准确率较低。培训课程和研讨会有助于提高初级读者的诊断准确性。
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来源期刊
BMC Rheumatology
BMC Rheumatology Medicine-Rheumatology
CiteScore
3.80
自引率
0.00%
发文量
73
审稿时长
15 weeks
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