Impact of Patient-reported Symptom Information on the Interpretation of MRI of the Lumbar Spine.

IF 12.1 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Radiology Pub Date : 2024-10-01 DOI:10.1148/radiol.233487
Rene Balza, Sarah F Mercaldo, Ambrose J Huang, Jad S Husseini, Mohamed Jarraya, F Joseph Simeone, Joao R T Vicentini, William E Palmer
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引用次数: 0

Abstract

Background Distinguishing lumbar pain generators from incidental findings at MRI can be difficult. Dictated reports may become lists of findings that cannot be ranked in order of diagnostic importance. Purpose To determine whether patient-reported symptom information can improve the interpretation of lumbar spine MRI by using the spine specialist as the reference standard. Materials and Methods This prospective, single-center, multireader study analyzed 240 participants who completed pre-MRI symptom questionnaires between May 2022 and February 2023. At the time of clinical MRI reporting, radiologists recorded pain generators in consecutive participants, creating two study groups by alternating interpretations with versus without symptom questionnaire results (SQR). Diagnostic certainty was recorded using a numeric scale of 0 to 100. Types, levels, and sides of pain generators were compared with reference diagnoses by calculating Cohen κ values with 95% CIs. Participant characteristics and diagnostic certainties were compared using the Wilcoxon rank sum, Pearson χ2, or Kruskal-Wallis test. Interrater agreement was analyzed. Results There was no difference in age (P = .69) or sex (P = .60) between participants using SQR (n = 120; mean age, 61.0 years; 62 female) and not using SQR (n = 120; mean age, 62.5 years; 67 female). When radiologists were compared with specialists, agreements on pain generators were almost perfect for interpretations using SQR (type: κ = 0.82 [95% CI: 0.74,0.89]; level: κ = 0.88 [95% CI: 0.80, 0.95]; side: κ = 0.84 [95% CI: 0.75, 0.92]), but only fair to moderate for interpretations not using SQR (type: κ = 0.26 [95% CI: 0.15, 0.36]; level: κ = 0.51 [95% CI: 0.39, 0.63]; side: κ = 0.30 [95% CI: 0.18, 0.42]) (all P < .001). Diagnostic certainty was higher for MRI interpretations using SQR (mean, 80.4 ± 14.9 [SD]) than MRI interpretations not using SQR (60.5 ± 17.7) (P < .001). Interrater agreements were substantial (κ = 0.65-0.78) for MRI interpretations using SQR but only fair to moderate (κ = 0.24-0.49) for MRI interpretations not using SQR (all P < .001). Conclusion Patient-reported symptom information enabled radiologists to achieve nearly perfect diagnostic agreement with clinical experts. © RSNA, 2024 See also the editorial by Isikbay and Shah in this issue.

患者报告的症状信息对腰椎核磁共振成像解读的影响。
背景 从磁共振成像的偶然发现中区分腰痛发生器可能很困难。口述报告可能会成为无法按诊断重要性排序的检查结果清单。目的 通过将脊柱专科医生作为参考标准,确定患者报告的症状信息是否能改善腰椎 MRI 的判读。材料和方法 这项前瞻性、单中心、多读取器研究分析了 2022 年 5 月至 2023 年 2 月间完成 MRI 前症状问卷调查的 240 名参与者。在临床 MRI 报告时,放射科医生记录了连续参与者的疼痛发生器,通过交替解释有症状问卷结果(SQR)和无症状问卷结果(SQR)来创建两个研究组。诊断确定性采用 0 到 100 的数字量表进行记录。通过计算 Cohen κ 值和 95% CIs,将疼痛发生器的类型、程度和侧面与参考诊断进行比较。使用 Wilcoxon 秩和检验、Pearson χ2 检验或 Kruskal-Wallis 检验比较参与者特征和诊断确定性。分析了研究者之间的一致性。结果 使用 SQR 的参与者(n = 120;平均年龄 61.0 岁;女性 62 人)与未使用 SQR 的参与者(n = 120;平均年龄 62.5 岁;女性 67 人)在年龄(P = .69)或性别(P = .60)方面没有差异。当放射科医生与专科医生进行比较时,使用 SQR 的判读几乎完全一致(类型:κ = 0.82 [95% CI:0.74,0.89];水平:κ = 0.88 [95% CI:0.80,0.95];侧面:κ = 0.84[95%CI:0.75,0.92]),而未使用 SQR 的判读结果仅为一般至中等(类型:κ = 0.26 [95% CI:0.15,0.36];水平:κ = 0.51 [95% CI:0.39,0.63];侧面:κ = 0.30 [95% CI:0.18,0.42])(所有 P <0.001)。与未使用 SQR 的 MRI 解释(60.5 ± 17.7)相比,使用 SQR 的 MRI 解释的诊断确定性更高(平均值为 80.4 ± 14.9 [标码])(P < .001)。使用 SQR 的核磁共振成像判读结果的互译一致性很高(κ = 0.65-0.78),而未使用 SQR 的核磁共振成像判读结果的互译一致性仅为一般至中等(κ = 0.24-0.49)(P < .001)。结论 患者报告的症状信息使放射科医师与临床专家的诊断几乎完全一致。RSNA, 2024 另请参阅本期 Isikbay 和 Shah 的社论。
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
Radiology
Radiology 医学-核医学
CiteScore
35.20
自引率
3.00%
发文量
596
审稿时长
3.6 months
期刊介绍: Published regularly since 1923 by the Radiological Society of North America (RSNA), Radiology has long been recognized as the authoritative reference for the most current, clinically relevant and highest quality research in the field of radiology. Each month the journal publishes approximately 240 pages of peer-reviewed original research, authoritative reviews, well-balanced commentary on significant articles, and expert opinion on new techniques and technologies. Radiology publishes cutting edge and impactful imaging research articles in radiology and medical imaging in order to help improve human health.
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