结构化清单辅助与否对MRI诊断RAMP损伤可靠性的影响：一项200例MRI研究
简介
该研究旨在评估使用结构化清单诊断半月板RAMP损伤的MRI可靠性。共纳入200例膝关节MRI，由4名运动医学医生分为两组：一组使用清单，另一组不使用。结果显示，使用清单组的诊断一致性显著更高（Cohen's kappa=0.779，一致率89%），而未使用组一致性极低（kappa=0.057，一致率60.5%）。1个月后两组均使用清单，诊断一致性改善至kap…
英文摘要
PURPOSE: This study intended to evaluate the reliability of diagnosing meniscal RAMP lesions on magnetic resonance imaging (MRI) using a newly developed identification checklist. The primary objective was to standardise MRI interpretation to reduce operator-dependent variability and enhance diagnostic agreement. METHODS: In total, 1350 knee MRI scans were initially reviewed, with 200 matching the predefined inclusion and exclusion criteria. Four sports medicine surgeons were divided into two groups: one using the developed RAMP lesion identification checklist and the other interpreting the MRI scans without it. Interobserver reliability was assessed using Cohen's kappa coefficient at two distinct time points. After 1 month, both groups reassessed the MRI scans using the checklist. The Intraclass Correlation Coefficient (ICC) was also calculated to determine the overall diagnostic consistency between the groups. RESULTS: The introduction of the checklist significantly improved interobserver reliability. In the initial evaluation, the group using the checklist exhibited a higher level of diagnostic agreement (Cohen's kappa = 0.779, 89% agreement) compared to the group without the checklist (Cohen's kappa = 0.057, 60.5% agreement). After 1 month, when both groups used the checklist, diagnostic concordance improved substantially (Cohen's kappa = 0.698, 85% agreement). The ICC between the groups indicated strong diagnostic consistency (0.759), further highlighting the checklist's effectiveness. CONCLUSIONS: The RAMP lesion identification checklist significantly enhances the reliability of MRI-based diagnoses by standardising the interpretation process and reducing observer variability. This protocol offers significant value in the preoperative setting by enhancing diagnostic consensus and surgeon confidence, ultimately allowing for more comprehensive surgical planning. However, further validation studies comparing MRI findings with direct arthroscopic evaluations are necessary to confirm its clinical utility. LEVEL OF EVIDENCE: Level 3.