MRVAS-introducing a standardized magnetic resonance scoring system for assessing the extent of inflammatory burden in giant cell arteritis.

IF 4.7 2区医学 Q1 RHEUMATOLOGY

Rheumatology Pub Date : 2024-10-01 DOI:10.1093/rheumatology/keae056

Matthias Froehlich, Konstanze V Guggenberger, Marius Vogt, Patrick W Mihatsch, Giulia Dalla Torre, Rudolf A Werner, Michael Gernert, Patrick P Strunz, Jan Portegys, Andreas M Weng, Marc Schmalzing, Thorsten A Bley

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Abstract

Objectives: Our aim was to introduce a standardized system for assessing the extent of GCA on MRI, i.e. the Magnetic Resonance Vasculitis Activity Score (MRVAS). To obtain a comprehensive view, we used an extensive MRI protocol including cranial vessels and the aorta with its branches. To test reliability, MRI was assessed by four readers with different levels of experience.

Methods: A total of 80 patients with suspected GCA underwent MRI of the cranial arteries and the aorta and its branches (20 vessel segments). Every vessel was rated dichotomous [inflamed (coded as 1) or not (coded as 0)], providing a summed score of 0-20. Blinded readers [two experienced radiologists (ExR) and two inexperienced radiologists (InR)] applied the MRVAS on an individual vessel and an overall level (defined as the highest score of any of the individual vessel scores). To determine interrater agreement, Cohen's κ was calculated for pairwise comparison of each reader for individual vessel segments. Intraclass correlation coefficients (ICCs) were used for the MRVAS.

Results: Concordance rates were excellent for both subcohorts on an individual vessel-based (GCA: ICC 0.95; non-GCA: ICC 0.96) and overall MRVAS level (GCA: ICC 0.96; non-GCA: ICC 1.0). Interrater agreement yielded significant concordance (P < 0.001) for all pairs (κ range 0.78-0.98). No significant differences between ExRs and InRs were observed (P = 0.38).

Conclusion: The proposed MRVAS allows standardized scoring of inflammation in GCA and achieved high agreement rates in a prospective setting.

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MRVAS 评分--引入标准化磁共振评分系统，评估巨细胞动脉炎的炎症负担程度。

目的：我们的目的是引入一套标准化系统，用于在 MRI 上评估巨细胞动脉炎（GCA）的程度，名为 MRVAS（MR 血管炎活动评分）。为了获得全面的视图，我们采用了广泛的 MRI 方案，包括颅内血管和主动脉及其分支。方法：80 名疑似 GCA 患者接受了头颅动脉和主动脉/分支（20 个血管节段）的 MRI 检查。每条血管都被评为二分法[有炎症（编码为 1）或无炎症 0]，总分从 0 到 20。盲读员（两名经验丰富的放射科医师 [ExR]、两名经验不足的放射科医师 [InR]）将 MRVAS 应用于单个血管和总体水平（定义为单个血管评分中的最高分）。为了确定判读者之间的一致性，计算了科恩卡帕（Cohen's kappa），对每个判读者的单个血管片段进行配对比较。MRVAS评分采用类内相关系数（ICC）：基于单个血管（GCA，ICC，0.95；非 GCA，ICC，0.96）和 MRVAS 总体评分（GCA，ICC，0.96；非 GCA，ICC，1.0）的两个子队列的一致性都非常好。所有数据对（kappa 范围为 0.78-0.98）均显示出明显的一致性（p< 0.001）。ER 和 IR 之间无明显差异（p= 0.38）：结论：拟议的 MRVAS 评分可对 GCA 的炎症进行标准化评分，并在前瞻性研究中取得了较高的一致率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Rheumatology 医学-风湿病学

CiteScore

9.40

自引率

7.30%

发文量

1091

审稿时长

2 months

期刊介绍： Rheumatology strives to support research and discovery by publishing the highest quality original scientific papers with a focus on basic, clinical and translational research. The journal’s subject areas cover a wide range of paediatric and adult rheumatological conditions from an international perspective. It is an official journal of the British Society for Rheumatology, published by Oxford University Press. Rheumatology publishes original articles, reviews, editorials, guidelines, concise reports, meta-analyses, original case reports, clinical vignettes, letters and matters arising from published material. The journal takes pride in serving the global rheumatology community, with a focus on high societal impact in the form of podcasts, videos and extended social media presence, and utilizing metrics such as Altmetric. Keep up to date by following the journal on Twitter @RheumJnl.