大骨节病X线诊断的一致度分析

THE OBSERVED AGREEMENT ANALYSIS OF THE RADIOLOGICAL DIAGNOSIS FOR KASHIN-BECK DISEASE

本文报道了两组Ｘ线诊断者对１９４例大骨节病Ｘ线诊断的一致度分析结果。结果表明，大骨节病干骺端与骨端Ｘ线病变、病例诊断的一致率分别为８９．７４％、９０．２１％、９０．２１％，Ｋａｐｐａ值在０．７６～０．８０间，证明两组诊断者应用现试行的Ｘ线诊断标准的诊断一致度属于极好范围。同时发现诊断的不一致率在９．７８％～１０．２６％间，其主要原因是难以鉴别掌指骨干骺端与骨端的早期Ｘ线征与正常变异。作者认为建立一个大骨节病Ｘ线诊断的标准图谱将会提高诊断的一致度和准确性。

This paper reports the results of the observed agreement analysis for 194 cases of Kashin-Beck disease diagnosed by two groups of radiologists.The result showed that the diagnostic observed agreement rate in metaphysis,the distal end of bone and the cases with Kashin-Beck disease were 89.74%,90.21%and 90.21%respectively on the x-rays film of hands.The Kappa value was from 0.76 to 0.80.This confirmed that the observed agreement of two groups of experts who diagnosed Kashin-Beck disease based on″The National Radiological Criterion of Kashin-Beck Disease″ was in the substantial levels.Meanwhile,the observed disagreement rate to diagnose this disease was in 9.78%～10.25%,The main cause of the latter was to difficultly differentiate the mild abnormal radiological findings and the normal variation of children's hands.hands.The anthors consider that the observed agreement and the accuracy to diagnose Kashin-Beck disease will be increased if the atlas of the standard radiographs to diagnose this disease Will be up in future.