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肌肉脂化率主观评分法的稳定性与可靠性研究

The study of stability and reliability of subjective semi-quantitative grading method for leg muscle fatty infiltration in dystrophinopathy
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摘要 目的:比较3位阅片者肌肉脂化率主观评分结果的一致性,分析主观评分法与客观评分法的相关性,评价抗肌萎缩蛋白病中肌肉脂肪浸润主观评分法的稳定性及可靠性。方法:搜集本院2012年1月-2015年8月抗肌萎缩蛋白病患者194例,行双下肢横轴面T1WI及IDEAL-Quant序列扫描。在横轴面T1WI图像中,由3位不同阅片者分别对所有患者下肢肌肉脂肪浸润程度进行两次主观盲法评分;在IDEAL-Quant脂肪图中测量得出肌肉脂化率。利用kappa检验分析各位阅片者自身及不同阅片者之间主观评分结果的一致性,使用spearman相关模型分析主观评分与IDEALQuant序列脂化率定量结果的相关性。结果:在对所有大腿肌肉脂肪浸润的主观半定量评估中,三位阅片者两次阅片评分结果自身比较Kappa值分别为0.75、0.54、0.55;三位阅片者之间阅片评分结果 Kappa值分别为0.54、0.23、0.22。主观评分结果与客观定量结果相关(r=0.60~0.92,P〈0.05)。但主观评分估计的脂肪浸润程度高于客观定量结果。结论:主观评分法的结果相对稳定、可靠,但与临床经验有关;主观评分法会高估肌肉脂肪浸润程度。 Objective:To analyze the intra-observer and inter-observer agreement of subjective semi-quantitative grading scores.Then to compare subjective semi-quantitative grading method with objective fat quantification method in assessing leg muscle fatty infiltration in dystrophinopathy.Methods:One hundred and ninety-four boys with genetically and/or pathologically confirmed dystrophinopathy were recruited.The axial T1-weighted images and IDEAL-Quant fat fraction maps were obtained.The axial T1-weighted images were visually evaluated by three readers subjectively.The objective muscle fat fraction value could be automatically calculated on GE AW4.6workstation based on fat fraction maps of IDEALQuant sequence.The kappa analysis was used to analyze the intra-and inter-observer agreement.The Spearman correlation was used to compare the two methods.Boxplot diagrams were used to show the differences between them.Results:The average intra-observer agreement values for all the muscles were 0.75,0.54 and 0.55 respectively.The average inter-observer agreement values for all the muscles were 0.54,0.23 and 0.22 respectively.Significant positive correlation was shown between the semi-quantitative and quantitative methods of all the muscles with the correlation coefficient varied from 0.60to0.92(P0.05),except for the internal obturator muscle and the adductor longus.However,the fat infiltration level evaluated by the semi-quantitative method was higher than the objective method.Conclusion:Subjective semi-quantitative grading method was reliable and stable in evaluating leg muscle fatty infiltration in dystrophinopathy.The Stability was correlated with observer's clinical experience.But the subjective semi-quantitative grading method can overestimate the fatty infiltration level.
出处 《放射学实践》 北大核心 2016年第3期262-266,共5页 Radiologic Practice
关键词 磁共振成像 抗肌萎缩蛋白病 骨骼肌 脂肪浸润 Magnetic resonance imaging Dystrophinopathy Skeletal muscle Fat infiltration
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参考文献15

  • 1Hilton TN,Tuttle LJ, Bohnert KL, et al. Excessive adipose tissue infiltration in skeletal muscle in individuals with obesity,diabetes mellitus,and peripheral neuropathy: association with performance and function[J]. Physical Therapy, 2008,88( 11 ) : 1336-1344.
  • 2王新德,沈定国,吴士文,等.神经病学:肌肉疾病[M].北京:人民军医出版社,2007:150-154,214-222.
  • 3Ishu A,Willcocks RJ,Forbes SC,et al. Examination of effects of corticosteroids on skeletal muscles of boys with DMD using MRI and MRS[J]. Neurology, 2014,83 ( 11 ) :974-980.
  • 4Fisehmann A,Hafner P,Gloor M,et al. Quantitative MRI and loss of free ambulation in Duchenne muscular dystrophy[J]. J Neurol. 2013,260(4) :969-974.
  • 5Li W,Zheng Y,Wei Z,et al. Progression and variation of fatty in filtration of the thigh muscles in Duehenne muscular dystrophy,a muscle magnetic resonance imaging study[J]. NMD,2015,25(5) : 375-380.
  • 6李文竹,郑艺明,杜婧,张巍,吕鹤,王朝霞,肖江喜,袁云.迪谢内肌营养不良骨骼肌磁共振成像研究[J].中华神经科杂志,2014,47(1):16-20. 被引量:15
  • 7Mercuri E,Pichiecchio A, Allsop J,et al. Muscle MRI in inherited neuromuscular disorders : past, present, and future[J]. J Magn Re son Imaging, 2007,25 (2) : 433-440.
  • 8Kim H K, Laor T, Horn PS,et al. Tz mapping in I)uehenne muscu lar dystrophy:distribution of disease activity and correbltion with clinical assessment s[J]. Radiology, 2010,255 ( 3 ) : 899-908.
  • 9杜婧,程晓悦,肖江喜,袁云,朱颖,刘琳琳,李飞宇,王霄英.常规MRI及功能MRI诊断抗肌萎缩蛋白病[J].中国医学影像技术,2014,30(9):1399-1402. 被引量:3
  • 10Bushby K, Finkel R, Birnkrant DJ, et al. Diagnosis and manage ment of Duchenne muscular dystrophy, part 1 : diagnosis, and pharmacological and psychosocial management [J]. Lancet Neu- rol,2010,9(1) :77-93.

二级参考文献34

  • 1Bushby K,Finkel R,Birnkrant DJ,et al.Diagnosis and manage-ment of Duchenne muscular dystrophy,part 1:Diagnosis,and pharmacological and psychosocial management.Lancet Neurol,2010,9(1):77-93.
  • 2Kim HK,Laor T,Horn PS,et al.T2 Mapping in Duchenne muscular dystrophy:Distribution of disease activity and correla-tion with clinical assessments.Radiology,2010,255(3):899-908.
  • 3Costa AF,Di Primio GA,Schweitzer ME.Magnetic resonance imaging of muscle disease:A pattern-based approach.Muscle Nerve,2012,46(4):465-481.
  • 4Kim HK,Merrow AC,Shiraj S,et al.Analysis of fatty.infiltra-tion and inflammation of the pelvic and thigh muscles in boys with Duchenne muscular dystrophy(DMD):Grading of disease in-volvement on MR imaging and correlation with clinical assess-ments.Pediatr Radiol,2013,43(10):1327-1335.
  • 5Kim HK,Laor T,Horn PS,et al.Quantitative assessment of the T2 relaxation time of the gluteus muscles in children with Duchenne muscular dystrophy:A comparative study before and after steroid treatment.Korean J Radiol,2010,11(3):304-311.
  • 6Forbes SC,Lott DJ,Finkel RS,et al.MRI/MRS evaluation of a female carrier of Duchenne muscular dystrophy.Neuromuscul Disord.2012.22:S111-S121.
  • 7Kim HK,Laor T,Horn PS. T2 mapping in Duchenne muuscular dystrophy:distribution of disease activity and correlation with clinical assessments[J].RADIOLOGY,2010.899-908.
  • 8Akima H,Lott D,Senesac C. Relationships of thigh muscle contractile and non-contractile tissue with function,strength,and age in boys with Duchenne muscular dystrophy[J].Neuromuscular Disorders,2012.16-25.
  • 9Klingler W,Jurkat-Rott K,Lehmann-Hom F. The role of fibrosis in Duchenne muscular dystrophy[J].Acta Myol,2012.184-195.
  • 10Mathur S,Lott DJ,Senesac C. Age-related differences in lower-limb muscle cross-sectional area and torque production in boys with Duchenne muscular dystrophy[J].Archives of Physical Medicine and Rehabilitation,2010.1051-1058.

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