Sacroilitis on magnetic resonance imaging in children presenting with low backache: interobserver reliability between radiologists

Background: The Kaplan fibers (KFs) of the iliotibial band have been suggested to play a role in anterolateral rotational instability of the knee, particularly in the setting of an anterior cruciate ligament (ACL) rupture. Description of the normal magnetic resonance imaging (MRI) anatomy of the KFs may facilitate subsequent investigation into the MRI signs of injury. Purpose: To assess if the KF complex can be identified on 3-T MRI using standard knee protocols. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: 3-T MRI scans of 50 ACL-intact knees were reviewed independently by a musculoskeletal radiologist and 2 orthopaedic surgeons. Identification of the KFs was based on radiological diagnostic criteria developed a priori. Identification of the KFs in the sagittal, coronal, and axial planes was recorded. Interobserver reliability was assessed using the Kappa statistic. Detailed anatomy including distance to the joint line and relationship to adjacent structures was recorded. Results: The mean patient age was 43 years (range, 15-81 years), 58% were male, and 50% were right knees. The KFs were identified by at least 2 reviewers on the sagittal images in 96% of cases, on the axial images in 76% of cases, and on the coronal images in 4% of cases. The mean distance from the KF distal femoral insertion to the lateral joint line was 50.1 mm (SD, 6.6 mm) and the mean distance to the lateral gastrocnemius tendon origin was 10.8 mm (SD, 8.6 mm). The KFs were consistently identified immediately anterior to the superior lateral geniculate artery on sagittal imaging. Interobserver reliability for identification was best in the sagittal plane (Kappa 0.5) and worst in the coronal plane (Kappa 0.1). Conclusion: The KF complex can be identified on routine MRI sequences in the ACL-intact knee; however, there is low to moderate interobserver reliability. Imaging in the sagittal plane had the highest rate of identification and the coronal plane the lowest. There is a consistent relationship between the most distal KF femoral attachment and the lateral joint line, lateral gastrocnemius tendon, and superior lateral geniculate artery.

Download Full-text

Interobserver reliability of the classification of capitellar osteochondritis dissecans using magnetic resonance imaging

Shoulder & Elbow ◽

10.1177/1758573218821151 ◽

2019 ◽

Vol 12 (4) ◽

pp. 284-293 ◽

Cited By ~ 1

Author(s):

Rens Bexkens ◽

F. Joseph Simeone ◽

Denise Eygendaal ◽

Michel PJ van den Bekerom ◽

Luke S Oh ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Osteochondritis Dissecans ◽

Interobserver Agreement ◽

Interobserver Reliability ◽

Lateral Wall ◽

Magnetic Resonance Images ◽

Resonance Imaging ◽

Instability Criteria

Aim (1) To determine the interobserver reliability of magnetic resonance classifications and lesion instability criteria for capitellar osteochondritis dissecans lesions and (2) to assess differences in reliability between subgroups. Methods Magnetic resonance images of 20 patients with capitellar osteochondritis dissecans were reviewed by 33 observers, 18 orthopaedic surgeons and 15 musculoskeletal radiologists. Observers were asked to classify the osteochondritis dissecans according to classifications developed by Hepple, Dipaola/Nelson, Itsubo, as well as to apply the lesion instability criteria of DeSmet/Kijowski and Satake. Interobserver agreement was calculated using the multirater kappa (k) coefficient. Results Interobserver agreement ranged from slight to fair: Hepple (k = 0.23); Dipaola/Nelson (k = 0.19); Itsubo (k = 0.18); DeSmet/Kijowksi (k = 0.16); Satake (k = 0.12). When classifications/instability criteria were dichotomized into either a stable or unstable osteochondritis dissecans, there was more agreement for Hepple (k = 0.52; p = .002), Dipaola/Nelson (k = 0.38; p = .015), DeSmet/Kijowski (k = 0.42; p = .001) and Satake (k = 0.41; p < .001). Overall, agreement was not associated with the number of years in practice or the number of osteochondritis dissecans cases encountered per year (p > .05). Conclusion One should be cautious when assigning grades using magnetic resonance classifications for capitellar osteochondritis dissecans. When making treatment decisions, one should rather use relatively simple distinctions (e.g. stable versus unstable osteochondritis dissecans; lateral wall intact versus not intact), as these are more reliable.

Download Full-text

Accuracy and Interobserver Reliability of Magnetic Resonance Imaging for Placenta Accreta Spectrum Disorders

American Journal of Perinatology ◽

10.1055/s-0040-1701196 ◽

2020 ◽

Author(s):

Brett D. Einerson ◽

Christina E. Rodriguez ◽

Robert M. Silver ◽

Meghan A. Donnelly ◽

Anne M. Kennedy ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Predictive Value ◽

Placenta Accreta ◽

Interobserver Reliability ◽

Diagnostic Testing ◽

Kappa Statistics ◽

Resonance Imaging ◽

Mri Findings ◽

Placenta Accreta Spectrum

Abstract Objective This study aims to define the accuracy, predictive value, and interobserver reliability of magnetic resonance imaging (MRI) in the diagnosis of placenta accreta spectrum (PAS) disorders. Study Design Two experienced radiologists independently interpreted the MRI studies of patients with possible PAS from two referral centers. Radiologists were blinded to sonographic and clinical information. We calculated diagnostic testing characteristics and kappa statistics of interobserver reliability for MRI findings of PAS. Results Sixty-eight MRI cases were evaluated. Confirmed PAS and severe PAS were present in 44 (65%) and 20 (29%) cases. For the diagnosis of any PAS, MRI had a sensitivity 66%, specificity 71%, positive predictive value (PPV) 81%, negative predictive value (NPV) 53%, and accuracy 68%. For the diagnosis of severe PAS (percreta), MRI had a sensitivity 85%, specificity 79%, PPV 63%, NPV 93%, and accuracy 81%. The accuracy of individual signs of PAS was lower (44–65%). Interobserver agreement was almost perfect for previa; substantial for myometrial interruptions, PAS, severe PAS, and placental bulging/balling; and moderate to slight for other signs of PAS. Conclusion Although the interobserver reliability of MRI for a diagnosis of PAS is substantial, the accuracy and predictive value are modest and lower than previously reported.

Download Full-text

Interobserver agreement for detecting Hill-Sachs lesions on magnetic resonance imaging

Clinics in Shoulder and Elbow ◽

10.5397/cise.2021.00115 ◽

2021 ◽

Vol 24 (2) ◽

pp. 98-105

Author(s):

Hassanin Alkaduhimi ◽

Aïmane Saarig ◽

Ihsan Amajjar ◽

Just A. van der Linde ◽

Marieke F. van Wier ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Interobserver Agreement ◽

Interobserver Reliability ◽

Patient Characteristics ◽

Accurate Diagnosis ◽

Bonferroni Correction ◽

Resonance Imaging ◽

Similar Appearance ◽

Magnetic Resonance Imaging Mri

Background: Our aim is to determine the interobserver reliability for surgeons to detect Hill-Sachs lesions on magnetic resonance imaging (MRI), the certainty of judgement, and the effects of surgeon characteristics on agreement. Methods: Twenty-nine patients with Hill-Sachs lesions or other lesions with a similar appearance on MRIs were presented to 20 surgeons without any patient characteristics. The surgeons answered questions on the presence of Hill-Sachs lesions and the certainty of diagnosis. Interobserver agreement was assessed using the Fleiss’ kappa (κ) and percentage of agreement. Agreement between surgeons was compared using a technique similar to the pairwise t-test for means, based on large-sample linear approximation of Fleiss' kappa, with Bonferroni correction. Results: The agreement between surgeons in detecting Hill-Sachs lesions on MRI was fair (69% agreement; κ, 0.304; p<0.001). In 84% of the cases, surgeons were certain or highly certain about the presence of a Hill-Sachs lesion. Conclusions: Although surgeons reported high levels of certainty for their ability to detect Hill-Sachs lesions, there was only a fair amount of agreement between surgeons in detecting Hill-Sachs lesions on MRI. This indicates that clear criteria for defining Hill-Sachs lesions are lacking, which hampers accurate diagnosis and can compromise treatment.

Download Full-text

Optimization of the Image Contrast for the Developing Fetal Brain using 3D Radial VIBE Sequence in 3T Magnetic Resonance Imaging

10.21203/rs.3.rs-902746/v1 ◽

2021 ◽

Author(s):

Yi Liao ◽

Xuesheng Li ◽

Fenglin Jia ◽

Zhijun Ye ◽

Gang Ning ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Image Quality ◽

Gray Matter ◽

Interobserver Reliability ◽

Fetal Brain ◽

Flip Angle ◽

Image Contrast ◽

Resonance Imaging ◽

Radial Vibe

Abstract Background: Faster and motion robust magnetic resonance imaging (MRI) sequences are desirable in fetal brain MRI. T1-weighted images are essential for evaluating fetal brain development. We optimized the radial volumetric interpolated breath-hold examination (VIBE) sequence for qualitative T1-weighted images of the fetal brain with improved image contrast and reduced motion sensitivity. Materials and Methods: This was an institutional review board-approved prospective study. Thirty-two pregnant subjects underwent fetal brain scan at 3 Tesla MRI. T1-weighted images were acquired using a 3D radial VIBE sequence with flip angles of 6º, 9º, 12º, and 15º and turbo FLASH (TFL) sequence. Qualitative assessments including image quality and motion artifact severity were evaluated. The image contrast ratio between gray and white matter were measured. Interobserver reliability and intraobserver repeatability were assessed using intraclass correlation coefficient (ICC).Results: Interobserver reliability and intraobserver repeatability universally revealed almost perfect agreement (ICC > 0.800). Significant differences in image quality were detected in basal ganglia (P < 0.001), central sulcus (P = 0.005), myelination (P < 0.001), lateral fissure (P = 0.008), optic chiasm (P < 0.001), and gray matter (P < 0.001) among radial VIBE with flip angles 6º, 9º, 12º, 15º and TFL groups. Image quality at the 9º flip angle in radial VIBE was generally better than TFL. Radial VIBE sequence with 9º flip angle of gray matter was significantly different by gestational age (GA) before and after 28 weeks (P = 0.036). Quantified image contrast was significantly different among protocols, consistent with qualitative analysis of image quality.Conclusions: Three-dimensional radial VIBE with 9º flip angle provides optimal, stable T1-weighted images of the fetal brain. Fetal brain structure and development can be evaluated using high-quality images obtained using this angle.

Download Full-text

Preliminary Results of Relationship between Preoperative Walking Ability and Magnetic Resonance Imaging Morphology in Patients with Lumbar Canal Stenosis: Comparison between Trefoil and Triangle Types of Spinal Stenosis

Asian Spine Journal ◽

10.4184/asj.2017.11.4.580 ◽

2017 ◽

Vol 11 (4) ◽

pp. 580-585

Author(s):

Parisa Azimi ◽

Taravat Yazdanian ◽

Edward C. Benzel

Keyword(s):

Magnetic Resonance Imaging ◽

Back Pain ◽

Magnetic Resonance ◽

Interobserver Reliability ◽

Walking Ability ◽

Resonance Imaging ◽

Perfect Agreement ◽

Duration Of Symptoms ◽

Lumbar Canal Stenosis ◽

Canal Stenosis

<sec><title>Study Design</title>Cross-sectional.</sec><sec><title>Purpose</title>To examine the relationship between magnetic resonance imaging (MRI) morphology stenosis grades and preoperative walking ability in patients with lumbar canal stenosis (LCS).</sec><sec><title>Overview of Literature</title>No previous study has analyzed the correlation between MRI morphology stenosis grades and walking ability in patients with LCS.</sec><sec><title>Methods</title>This prospective study included 98 consecutive patients with LCS who were candidates for surgery. Using features identified in T2-weighted axial magnetic, stenosis type was determined at the maximal stenosis level, and only trefoil and triangle stenosis grade types were considered because of sufficient sample size. Intraobserver and interobserver reliability were assessed by calculating weighted kappa coefficients. Symptom severity was evaluated via the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). Walking ability was assessed using the Self-Paced Walking Test (SPWT) and JOABPEQ subscales. Demographic characteristics, SPWT scores, and JOABPEQ scores were compared between patients with trefoil and triangle stenosis types.</sec><sec><title>Results</title>The mean patient age was 58.1 (standard deviation, 8.4) years. The kappa values of the MRI morphology stenosis grade types showed a perfect agreement between the stenosis grade types. The trefoil group (n=53) and triangle group (n=45) showed similar preoperative JOABPEQ subscale scores (e.g., low back pain, lumbar function, and mental health) and were not significantly different in age, BMI, duration of symptoms, or lumbar stenosis levels (all <italic>p</italic>>0.05); however, trefoil stenosis grade type was associated with a decreased walking ability according to the SPWT and JOABPEQ subscale scores.</sec><sec><title>Conclusions</title>These findings suggest preoperative walking ability is more profoundly affected in patients with trefoil type stenosis than in those with triangle type stenosis.</sec>

Download Full-text

Magnetic resonance imaging of sacroiliitis in children: frequency of findings and interobserver reliability

Pediatric Radiology ◽

10.1007/s00247-018-4185-x ◽

2018 ◽

Vol 48 (11) ◽

pp. 1621-1628 ◽

Cited By ~ 2

Author(s):

Katharine E. Orr ◽

Savvas Andronikou ◽

Marc James Bramham ◽

Izidora Holjar-Erlic ◽

Flavia Menegotto ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Interobserver Reliability ◽

Resonance Imaging

Download Full-text

A New Method for Measuring Glenoid Version on Standard Magnetic Resonance Imaging

Journal of Shoulder and Elbow Arthroplasty ◽

10.1177/2471549220926826 ◽

2020 ◽

Vol 4 ◽

pp. 247154922092682

Author(s):

Nicholas J. Maister ◽

Andrew Hely ◽

Liam G. Twycross ◽

Stephen D. Gill ◽

Richard S. Page

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Shoulder Instability ◽

Interobserver Reliability ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

New Method ◽

Resonance Imaging ◽

Glenoid Version ◽

Standard Magnetic Resonance Imaging

Background The most effective method and modality for measuring glenoid version for different shoulder conditions is uncertain. Computed tomography (CT) imaging exposes the patient to radiation, and standard magnetic resonance imaging (MRI) does not consistently image the entire scapula. This study investigates the reliability of a new method for assessing glenoid version using routine shoulder MRI. Methods MRI images of 20 patients undergoing arthroscopy for shoulder instability were independently assessed by 3 clinicians for osseous and chondrolabral glenoid version. To assess glenoid version, a line was drawn from medial corner of the glenoid body to midpoint of the glenoid face. A line perpendicular to this was the reference against which to measure glenoid version. Measurements were repeated after 3 months to assess intra- and interobserver reliability. Reliability was determined using intraclass correlation coefficients (ICCs). Results Interclass correlation coefficients showed at least good reliability for most estimates of intraobserver reliability (ICC ≥ .66) and excellent reliability for most estimates of interobserver reliability (ICC ≥ .84), with the exception of some inferior glenoid measurements where ICC was poor (ICC ≤.41). Discussion We propose that this new method of measuring glenoid on standard axial MRI can be used as a simple, practical, and reliable method in shoulder instability patients, which will reduce the requirement for CT in this group.

Download Full-text

Tibial cartilage volume measurement in knee osteoarthritis using magnetic resonance imaging

Asian Biomedicine ◽

10.5372/1905-7415.0901.366 ◽

2017 ◽

Vol 9 (1) ◽

pp. 41-47 ◽

Cited By ~ 1

Author(s):

Varalee Vanichtantikul ◽

Sarit Hongvilai ◽

Numphung Numkarunarunrote

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Disease Progression ◽

Interobserver Reliability ◽

Cartilage Degeneration ◽

Volume Measurement ◽

Cartilage Volume ◽

Response To Therapy ◽

Resonance Imaging ◽

Tibial Cartilage

Abstract Background Cartilage degeneration is considered as the initial defect in osteoarthritis. Measurement of cartilage volume is important to monitor disease progression and therapeutic response. Objectives To measure tibial cartilage volume using magnetic resonance imaging (MRI), and to evaluate the accuracy and interobserver reliability of tibial cartilage volume measurement using MRI. Methods The outline boundaries of the medial and lateral tibial cartilage were drawn manually on 1 mm slices using a track-ball to calculate the volume of each slice. Total calculated MRI-derived tibial cartilage volume was determined by summation of the slice volumes. The calculated tibial cartilage volume was compared to the actual tibial cartilage volume. Results There was a strong correlation between the calculated and actual tibial cartilage volumes determined by a radiologist and a researcher (98% and 89% agreement in medial tibial cartilage, 99% and 97% agreement in lateral tibial cartilage, respectively). High observer reliability was identified (92% agreement in medial tibial cartilage and 97% agreement in lateral tibial cartilage). Conclusion Tibial cartilage volume measurement using MRI can be easily performed by well-trained personnel such as radiologists or residents, and can be used to estimate tibial cartilage volume preoperatively in total knee arthroplasty, and to monitor disease progression and response to therapy.

Download Full-text

Development and Preliminary Validation of the Spondyloarthritis Research Consortium of Canada Magnetic Resonance Imaging Sacroiliac Joint Structural Score

The Journal of Rheumatology ◽

10.3899/jrheum.140519 ◽

2014 ◽

Vol 42 (1) ◽

pp. 79-86 ◽

Cited By ~ 66

Author(s):

Walter P. Maksymowych ◽

Stephanie Wichuk ◽

Praveena Chiowchanwisawakit ◽

Robert G. Lambert ◽

Susanne J. Pedersen

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Interobserver Reliability ◽

Intraclass Correlation ◽

Unmet Need ◽

Resonance Imaging ◽

Structural Progression ◽

Smallest Detectable Change ◽

Good For ◽

Research Consortium

Objective.There is an unmet need for reliable assessment of structural progression in the sacroiliac joints (SIJ) of patients with spondyloarthritis (SpA), but radiography is unreliable and lacks responsiveness. We aimed to develop and validate a new scoring method for structural lesions based on magnetic resonance imaging (MRI), the Spondyloarthritis Research Consortium of Canada (SPARCC) SIJ Structural Score (SSS).Methods.The SSS method for assessment of structural lesions is based on T1-weighted spin echo MRI, validated lesion definitions, slice selection according to well-defined anatomical principles, and dichotomous scoring (lesion present/absent) of 5 consecutive slices through the cartilaginous portion of the joint. Scoring ranges are fat metaplasia (0–40), erosion (0–40), backfill (0–20), and ankylosis (0–20). We progressively conducted 3 validation exercises with 2–4 readers on baseline, and either 2-year (exercises 1 and 2) or 1-year (exercise 3) scans from 147 patients with SpA assessed blinded to timepoint. Interobserver reliability was assessed by intraclass correlation coefficient (ICC) and smallest detectable change (SDC).Results.Interobserver reliability for status score was good to excellent for ankylosis (ICC 0.79–0.98), consistently good for fat metaplasia (ICC 0.71–0.78), moderate to good for erosion (ICC 0.58–0.62), and fair to good for backfill (ICC 0.35–0.66). Reliability for change scores was moderate to good for all structural lesions despite the relatively small changes in scores, and was highest for fat metaplasia when both ICC and SDC values were compared.Conclusion.The new SPARCC MRI SSS method can detect structural changes in the SIJ with acceptable reliability over a 1–2-year timeframe, and should be further validated in patients with SpA.

Download Full-text