Erica Cristina Scarpa, João C Lyra, Pedro L T de A Lourenção, Andréa S Hachem, Geraldo H S da Silva, Glauce R F Giacóia, Erika V P Ortolan, Camila de Paula Silva, Guilherme L da Silveira, Maria R Bentlin
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引用次数: 0
Abstract
Objective: The analysis of abdominal radiography is essential for the diagnosis and management of necrotizing enterocolitis (NEC) in newborns (NB). Studies, however, show a lack of agreement among physicians in the interpretation of images. This study aims to evaluate the agreement in the radiological interpretation of the NEC between examiners from different specialties (interexaminer analysis) and between the same examiner at different times (intraexaminer analysis).
Methods: Cross-sectional study for concordance analysis using plain radiographs of the abdomen of NB with suspected or confirmed NEC. The study included two neonatologists (Neo), two surgeons (SU), and two radiologists (RD). The participants filled out a form with questions about the radiographic findings; regarding the presence of intestinal loop distension, the specialists answered subjectively (yes or no) and objectively (calculation of the ratio between loop diameter and lumbar vertebrae measurements). Kappa coefficients were calculated for agreement analysis.
Results: A total of 90 radiological images were analyzed. For the interexaminer evaluation, the agreement was low (kappa<0.4) in 30 % of the answers (Neo versus SU), 38 % (Neo versus RD), and 46 % (SU versus RD). In the intraexaminer evaluation, the neonatologist and the surgeon presented substantial or almost perfect agreement in 92 % of the answers, and the radiologist in 77 %. In the evaluation of intestinal loop distention, the greatest agreement between the specialties occurred when done objectively.
Conclusion: The results confirmed the low intra- and interexaminer agreement in the radiological analysis of the NEC, reinforcing the importance of standardizing the methods of radiological interpretation of the disease.
目的：腹部放射线检查分析对于新生儿（NB）坏死性小肠结肠炎（NEC）的诊断和治疗至关重要。但研究表明，医生之间在图像解读方面缺乏一致性。本研究旨在评估来自不同专业的检查医师（检查医师间分析）和同一检查医师在不同时间（检查医师内分析）对新生儿坏死性小肠结肠炎的放射学解释的一致性：方法：横断面研究，使用疑似或确诊 NEC 的 NB 腹部平片进行一致性分析。研究对象包括两名新生儿科医生（Neo）、两名外科医生（SU）和两名放射科医生（RD）。参与者填写了一份表格，其中包含有关放射学检查结果的问题；对于是否存在肠套叠胀气，专家们给出了主观回答（是或否）和客观回答（计算肠套叠直径与腰椎测量值的比率）。计算卡帕系数用于一致性分析：共分析了 90 张放射图像。结果：共分析了 90 张放射影像，检查者之间的一致性较低（卡帕系数）：结论：结果证实，在对 NEC 进行放射学分析时，检查者内部和检查者之间的一致性较低，这进一步说明了对该疾病的放射学解释方法进行标准化的重要性。
期刊介绍：
Jornal de Pediatria is a bimonthly publication of the Brazilian Society of Pediatrics (Sociedade Brasileira de Pediatria, SBP). It has been published without interruption since 1934. Jornal de Pediatria publishes original articles and review articles covering various areas in the field of pediatrics. By publishing relevant scientific contributions, Jornal de Pediatria aims at improving the standards of pediatrics and of the healthcare provided for children and adolescents in general, as well to foster debate about health.
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