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

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.

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Agreement between magnetic resonance imaging, myelography, and surgery for detecting recurrent, thoracolumbar intervertebral disc extrusion in dogs

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-12-05-0067 ◽

2013 ◽

Vol 26 (01) ◽

pp. 12-18 ◽

Cited By ~ 5

Author(s):

B. A. Brisson ◽

S. G. Nykamp ◽

D. Reynolds

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Intervertebral Disc ◽

Interobserver Agreement ◽

Surgical Decompression ◽

Diagnostic Methods ◽

Resonance Imaging ◽

Disc Disease ◽

Recurrent Lesion ◽

Magnetic Resonance Imaging Mri

Summary Objectives: Although magnetic resonance imaging (MRI) is reported to be superior to myelography to determine the location and site of first time disc herniation, comparison of these diagnostic methods in cases of recurrent intervertebral disc disease (IVD) herniation after a first surgery has not been evaluated. The objective was to compare the diagnostic accuracy of MRI and myelography in a series of dogs undergoing repeat surgical decompression for recurrent IVD extrusion when compared to the gold standard of surgery. Methods: Ten dogs with recurrent IVD herniation underwent MRI and myelography followed by surgical decompression. Three observers reviewed the images to determine the site and side of the first surgery and the recurrent lesion. Agreement was determined by calculating a kappa (κ) score. Results: Substantial interobserver agreement was noted for recurrent lesion site using MRI and myelography (κ = 0.77 vs. 0.73) and when comparing MRI and myelography to the reported surgical site (κ = 0.73 vs. 0.67). Interobserver agreement was greater with MRI for circumferential location compared to myelography (κ = 0.76 vs. 0.43), similar to what was found when comparing to surgical side (κ = 0.82 vs. 0.49). The previous surgical site in this study had no effect on ability to identify the new lesion. Clinical significance: Despite the limitations of MRI, there was greater agreement between observers using MRI for both the recurrent and first lesion.

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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.

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Magnetic Resonance Imaging of the Hand in Systemic Sclerosis

The Journal of Rheumatology ◽

10.3899/jrheum.080795 ◽

2009 ◽

Vol 36 (5) ◽

pp. 961-964 ◽

Cited By ~ 40

Author(s):

ANDREA H.L. LOW ◽

MATTHEW LAX ◽

SINDHU R. JOHNSON ◽

PETER LEE

Keyword(s):

Magnetic Resonance Imaging ◽

Systemic Sclerosis ◽

Magnetic Resonance ◽

Accurate Diagnosis ◽

Joint Effusion ◽

Resonance Imaging ◽

Mri Findings ◽

Bone Edema ◽

Magnetic Resonance Imaging Mri

Objective.To evaluate the utility of magnetic resonance imaging (MRI) in systemic sclerosis (SSc)-associated arthropathy.Methods.MRI of the hand was performed in patients presenting with joint pain/swelling in order (1) to determine the frequency of inflammation on MRI, and (2) to compare MRI with radiography.Results.Of 17 patients with SSc, 10 (59%) had inflammatory MRI findings with synovitis (n = 8), erosions (n = 7), joint effusion (n = 7), or tenosynovitis (n = 8). Bone edema was present in 9 patients. Of 7 patients with MRI erosions, only 2 had radiographic erosions.Conclusion.Our study illustrates the usefulness of MRI in the accurate diagnosis and characterization of SSc-associated arthropathy.

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Histological Characteristics of Myxoid (Metaplastic) Meningioma in a 44-Year-Old Woman

Case Reports in Oncological Medicine ◽

10.1155/2019/9207632 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Akiko Marutani ◽

Ryou Nakano ◽

Noriyuki Nishi ◽

Tomonori Yamada

Keyword(s):

Magnetic Resonance Imaging ◽

Case Report ◽

Magnetic Resonance ◽

Accurate Diagnosis ◽

Resonance Imaging ◽

Who Grade ◽

Histological Features ◽

Histopathological Features ◽

Histological Characteristics ◽

Magnetic Resonance Imaging Mri

Myxoid (metaplastic) meningioma is the rarest WHO grade 1 meningioma, and its histological characteristics are useful in diagnostics. We present the case report of a myxoid (metaplastic) meningioma in a 44-year-old woman to highlight the important histological features and observations that are critical for making an accurate diagnosis. We report a rare myxoid meningioma using magnetic resonance imaging (MRI) images and its histopathological features.

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Quantitative Magnetic Resonance Imaging Analysis of the Common Site of Acute Achilles Tendon Rupture: 5 to 8 cm Above the Distal End of the Calcaneal Insertion

The American Journal of Sports Medicine ◽

10.1177/0363546519858990 ◽

2019 ◽

Vol 47 (10) ◽

pp. 2374-2379 ◽

Cited By ~ 2

Author(s):

Young Hwan Park ◽

Jung Wook Lim ◽

Gi Won Choi ◽

Hak Jun Kim

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Achilles Tendon ◽

Tendon Rupture ◽

Interobserver Reliability ◽

Achilles Tendon Rupture ◽

Patient Characteristics ◽

Resonance Imaging ◽

Significant Difference ◽

Rupture Site

Background: Previous studies have not quantitatively analyzed the site of acute Achilles tendon rupture. Purpose: To investigate the site of acute Achilles tendon rupture via magnetic resonance imaging (MRI). Study Design: Cross-sectional study; Level of evidence, 4. Methods: The medical records and MRIs of 195 patients with acute Achilles tendon rupture were retrospectively reviewed. The rupture site was measured as the distance from the most distal fibers of the Achilles tendon at the calcaneal insertion to the proximal end of the distal stump. The relationship between the site of rupture and patient characteristics was analyzed, and the intra- and interobserver reliability of the measurements was assessed using intraclass correlation coefficients. Results: The rupture site had a mean distance of 6.4 cm (SD, 1.5) and the 10th to 90th percentile range was 5.0 to 8.4 cm. There was no significant difference in location of the rupture according to patient characteristics and the time of imaging. The intra- and interobserver reliability of measurements was excellent. Conclusion: Most acute Achilles tendon ruptures visible on MRI occurred 5 to 8 cm above the distal end of the calcaneal insertion, which is more proximal than the previously reported 2 to 6 cm location.

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Glossal Abscess: An Unusual Presentation

Otorhinolaryngology Clinics - An International Journal ◽

10.5005/jp-journals-10003-1225 ◽

2016 ◽

Vol 8 (1) ◽

pp. 41-44

Author(s):

Shikha Goyal ◽

Freny Karjodkar ◽

Kaustubh Sansare ◽

Nimish Prakash ◽

Isha Mishra ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Accurate Diagnosis ◽

Unusual Presentation ◽

Proper Treatment ◽

Resonance Imaging ◽

Magnetic Resonance Imaging Mri

ABSTRACT Tongue is an organ, i.e., constantly exposed to microbes and likelihood of trauma, yet does not usually show a predilection for developing an abscess. Cases of acute lingual swelling due to an abscess are unusual; hemorrhage, infarction, edema, and tumor being the commonly responsible etiologies. Herein, we report a case of glossal abscess that was chronic in nature (2 months’ duration), presenting with uncharacteristic symptoms and no remission on taking antibiotics. In the absence of typical signs, Magnetic resonance imaging (MRI) provided an invaluable and accurate diagnosis, which allowed proper treatment to be rendered. How to cite this article Mishra I, Karjodkar F, Sansare K, Prakash N, Dora A, Goyal S. Glossal Abscess: An Unusual Presentation. Int J Otorhinolaryngol Clin 2016;8(1):41-44.

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Flexor Hallucis Longus Hypertrophy Secondary to Achilles Tendon Tendinopathy: An MRI-based Case-Control Study

10.21203/rs.3.rs-51795/v1 ◽

2020 ◽

Author(s):

Stephan Wirth ◽

Octavian Andronic ◽

Fabian Aregger ◽

Anna Jungwirth-Weinberger ◽

Thorsten Jentzsch ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Achilles Tendon ◽

Interobserver Agreement ◽

Achilles Tendinopathy ◽

Triceps Surae ◽

Flexor Hallucis Longus ◽

Resonance Imaging ◽

Mri Scans ◽

Magnetic Resonance Imaging Mri

Abstract Background: The purpose of this study was to outline indirect signs of advanced Achilles tendinopathy on magnetic resonance imaging (MRI) and develop a potential tool that could aid in surgical decision-making.Methods: Magnetic resonance imaging (MRI) scans of Achilles tendon were analyzed retrospectively in two consecutive cohorts. Control group consisted of patients that had an MRI due to other reasons and no signs of tendinopathy. Two parameters from two muscle bellies were measured and compared on axial MRI scans 4 to 5 cm above the ankle joint line at the level of greatest thickness: area and diameter of the triceps surae (TS) and of the flexor hallucis longus (FHL). Interobserver agreement was analyzed. A receiver operating characteristic (ROC) curve was created for both quotients to assess potential cut-off points.Results: A total of 60 patients for each study group were included. The ratios for area and for diameter showed significant higher values for FHL in the tendinopathy group (p<0.001). There was strong to very strong interobserver agreement (rho=0.744). A diameter ratio FHL/TS of 2.0 or higher had a sensitivity of 49% and specificity of 90% for concomitant Achilles tendinopathy.Conclusion: In our patient cohort, flexor hallucis longus hypertrophy was observed even before a tendon transfer was employed as a possible compensatory mechanism for Achilles tendon tendinopathy. Using the tool described in this study, measuring a value of 2.0 or higher on an axial MRI, may be indicative as an indirect sign of functional deterioration of the Achilles tendon.

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Magnetic resonance imaging of anterior cruciate ligament tears: evaluation of standard orthogonal and tailored paracoronal images

Acta Radiologica ◽

10.1080/02841850500215907 ◽

2005 ◽

Vol 46 (7) ◽

pp. 729-733 ◽

Cited By ~ 53

Author(s):

S. R. Duc ◽

M. Zanetti ◽

J. Kramer ◽

K. P. Käch ◽

C. L. Zollikofer ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Anterior Cruciate Ligament ◽

Magnetic Resonance ◽

Interobserver Agreement ◽

Cruciate Ligament ◽

Resonance Imaging ◽

Magnetic Resonance Imaging Mri ◽

Anterior Cruciate ◽

Cruciate Ligament Tears ◽

Imaging Plane

Purpose: To evaluate the three standard orthogonal imaging planes and a paracoronal imaging plane for anterior cruciate ligament (ACL) tears. Material and Methods: Ninety patients (91 knees; 29 F and 61 M) aged between 15 and 84 years (mean 36.9±16.4 years) underwent magnetic resonance imaging (MRI) of the knee prior to arthroscopy. At surgery, 32 knees had an intact ACL, 4 a partial tear, and 55 a complete ACL tear. In all patients, axial, sagittal, coronal, and paracoronal T2-weighted turbo-SE images were acquired. The ACL was classified as intact, partially, or completely torn. Partial and complete tears were combined for statistical evaluation. Results: Partial ACL tears (four cases) were not correctly diagnosed at MRI except in one knee by one observer on coronal images. Sensitivity in detecting ACL tears was 95%/63% (reader1/reader2) in the axial, 93%/95% in the sagittal, 93%/86% in the coronal, and 100%/93% in the paracoronal plane. Specificity was 75%/81% in the axial, 72%/81% in the sagittal, 78%/94% in the coronal, and 78%/88% in the paracoronal plane. Conclusion: ACL tears can be diagnosed accurately with each of the standard orthogonal planes. Based on reader confidence and interobserver agreement paracoronal images may be useful in equivocal cases.

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