目的:在有限的评分系统教学后,在不同经验水平的读者中,确定神经病变评分报告和数据系统(NS-RADS)的分类和严重程度量表的读者间可靠性和诊断性能。
方法:这是一个多机构,横截面,经证实的周围神经病(PN)的MRI病例的回顾性研究。从不同的机构招募了32名具有不同经验水平的放射学读者。每位读者都参加了并收到了结构化的演示文稿,该演示文稿描述了NS-RADS分类系统,其中包含示例并评论了有关该主题的已发表文章。然后要求读者进行NS-RADS评分并记录类别,子类别,最有可能的诊断。通过Conger的kappa评估读者间协议,并计算每个读者的诊断准确性,作为正确诊断的百分比。使用线性混合模型来估计和比较受训者和出席者之间的准确性。
结果:在所有读者中,NS-RADS类别的协议良好,子类别的协议中等。受训者的读者间协议与出席者相当(0.65vs0.65)。出席者的读者准确率为75%(95%CI73%,77%),略高于受训人员(71%(69%,72%),p=0.0006)对于神经和肌肉(出席,87.5%(95%CI86.1-88.8%)和受训人员,86.6%(95%CI85.2-87.9%),p=0.4)。NS-RADS准确度也高于主治放射科医生最合理诊断的平均准确度,为67%(95%CI63%,71%)和65%(95%CI60%,69%)(p=0.036)。
结论:非专家放射科医师使用NS-RADS评分系统以良好的准确性和中等至良好的读者间可靠性来解释PN条件。
结论:神经病变评分报告和数据系统(NS-RADS)是一种准确可靠的基于MRI的图像评分系统,可用于有经验的放射科医师和普通放射科医师对周围神经肌肉疾病的严重程度进行诊断和分级。
结论:•非专家放射科医师可以有效地使用神经病变评分报告和数据系统(NS-RADS)对周围神经病变进行分类。•跨32个不同的经验级读者,该协议对NS-RADS类别良好,对NS-RADS子类别中等.•NS-RADS准确性高于主治放射科医师和受训者最合理诊断的平均准确性(75%,71%和65%,65%,分别)。
OBJECTIVE: To determine the inter-reader reliability and diagnostic performance of classification and severity scales of Neuropathy Score Reporting And Data System (NS-RADS) among readers of differing experience levels after limited teaching of the scoring system.
METHODS: This is a multi-institutional, cross-sectional, retrospective study of MRI cases of proven peripheral neuropathy (PN) conditions. Thirty-two radiology readers with varying experience levels were recruited from different institutions. Each reader attended and received a structured presentation that described the NS-RADS classification system containing examples and reviewed published articles on this subject. The readers were then asked to perform NS-RADS scoring with recording of category, subcategory, and most likely diagnosis. Inter-reader agreements were evaluated by Conger\'s kappa and diagnostic accuracy was calculated for each reader as percent correct diagnosis. A linear mixed model was used to estimate and compare accuracy between trainees and attendings.
RESULTS: Across all readers, agreement was good for NS-RADS category and moderate for subcategory. Inter-reader agreement of trainees was comparable to attendings (0.65 vs 0.65). Reader accuracy for attendings was 75% (95% CI 73%, 77%), slightly higher than for trainees (71% (69%, 72%), p = 0.0006) for nerves and comparable for muscles (attendings, 87.5% (95% CI 86.1-88.8%) and trainees, 86.6% (95% CI 85.2-87.9%), p = 0.4). NS-RADS accuracy was also higher than average accuracy for the most plausible diagnosis for attending radiologists at 67% (95% CI 63%, 71%) and for trainees at 65% (95% CI 60%, 69%) (p = 0.036).
CONCLUSIONS: Non-expert radiologists interpreted PN conditions with good accuracy and moderate-to-good inter-reader reliability using the NS-RADS scoring system.
CONCLUSIONS: The Neuropathy Score Reporting And Data System (NS-RADS) is an accurate and reliable MRI-based image scoring system for practical use for the diagnosis and grading of severity of peripheral neuromuscular disorders by both experienced and general radiologists.
CONCLUSIONS: • The Neuropathy Score Reporting And Data System (NS-RADS) can be used effectively by non-expert radiologists to categorize peripheral neuropathy. • Across 32 different experience-level readers, the agreement was good for NS-RADS category and moderate for NS-RADS subcategory. • NS-RADS accuracy was higher than the average accuracy for the most plausible diagnosis for both attending radiologists and trainees (at 75%, 71% and 65%, 65%, respectively).