分析比较股骨滑车Dejour分型三种评估方法的可重复性与可信度  

Comparision of Repeatability and Reliability in Three Assessment Classification Methods of Dejour for Femoral Trochlear Morphology

作　　者：郑雷[1] 王燕[2] 赵昱东 王振宇 张政国 苏丹 纪丙军 ZHENG Lei;WANG Yan;ZHAO Yudong;WANG Zhenyu;ZHANG Zhengguo;SU Dan;JI Bingjun(Department of Radiology,Shandong Provincial Corps Hospital of Chinese People’s Armed Police Forces,Jinan Shandong 250014,China;Department of Medical Insurance Management,Shandong Provincial Corps Hospital of Chinese People’s Armed Police Forces,Jinan Shandong 250014,China;Department of Radiology,Sunshine Union Hospital,Weifang Shandong 261061,China)

机构地区：[1]武警山东总队医院医学影像科,山东济南250014 [2]武警山东总队医院医保管理科,山东济南250014 [3]阳光融和医院医学影像科,山东潍坊261061

出　　处：《德州学院学报》2025年第2期53-58,共6页Journal of Dezhou University

基　　金：潍坊市卫生健康委员会科研项目(WFWSJK-2021-269)。

摘　　要：选取31例患者的膝关节MRI(magnetic resconance imaging)资料(14例为髌骨外侧脱位患者,17例正常者),2名放射科医师分别采用股胫关节上方3 cm法、股骨滑车软骨完整覆盖法、髌骨中间高度位置法2次独立阅片,判断股骨滑车是否发育不良并进行Dejour分型,应用Kappa检验评价3种方法的可重复性和可信度。结果显示股胫关节上方3 cm法的可重复性和可信度Kappa系数分别为0.592、0.579和0.452,股骨滑车软骨完整覆盖法的可重复性和可信度Kappa系数分别为0.52、0.536和0.329,髌骨中间高度位置法的可重复性和可信度Kappa系数分别为0.711、0.634和0.593。研究发现对股骨滑车形态Dejour分型,三者比较髌骨中间高度位置法具有相对较好的可重复性和可信度,其次是股胫关节上方3 cm法,最后是股骨滑车完整覆盖法,判断层面的选择差异、不同分型间判定标准的主观意识差异可能是影响分型一致性的主要原因。The knee MRI data of 31 patients(14 patients with lateral patellar dislocation(LPD)and 17 normal individuals)were collected to compare the repeatability and reliability of Dejour classification of trochlear dysplasia on axial MR images at three different levels:3 cm above the femorotibial joint line(method 1),the most superior plane showing full trochlear cartilaginous coverage(method 2),and the plane of the midpatellar height(method 3).The Dejour classification of trochlear dysplasia in 31 patients was independently assessed and classified by two radiologists using the three methods as mentioned above,and the Kappa test was used to evaluate the repeatability and reliability.The results showed that the intra-observer repeatability and inter-observer reliability were 0.592,0.579 and 0.452 for classification method 1,0.52,0.536 and 0.329 for method 2,and 0.711,0.634 and 0.593 for method 3,respectively.Inconclusion,among the three axial planes for assessing Dejour classification of trochlear dysplasia,the plane of the midpatellar height have relatively good repeatability and reliability,followed by plane of 3 cm above the femorotibial joint line,and finally the most superior plane showing full trochlear cartilaginous coverage.Differences in the selection of the different axial level and poor subjective differences in the judgment criteria between different subtypes may be the main reasons that affect typing consistency.

关 键 词：膝关节 滑车发育不良 Dejour分型 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]