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Ultraschall Med 2019; 40(04): 481-487
DOI: 10.1055/a-0837-0712
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Interrater Reliability of Ultrasound in the Diagnosis of Sialolithiasis

Interrater-Reliabilität von Ultraschall bei der Diagnose von Sialolithiasis
Miguel Goncalves   *
1   Department of Otorhinolaryngology, Head-and-Neck-Surgery, FAU Medical School Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany
,
Konstantinos Mantsopoulos   *
1   Department of Otorhinolaryngology, Head-and-Neck-Surgery, FAU Medical School Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany
,
Mirco Lothar Schapher
1   Department of Otorhinolaryngology, Head-and-Neck-Surgery, FAU Medical School Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany
,
Johannes Zenk
2   Department of Otorhinolaryngology, Head-and-Neck-Surgery, Klinikum Augsburg, Germany
,
Alessandro Bozzato
3   Department of Otorhinolaryngology, Head-and-Neck-Surgery, University-Hospital Saarlanddical School, Homburg, Germany
,
Julian Kuenzel
4   Department of Otorhinolaryngology, Head-and-Neck-Surgery, Mainz-University-Hospital, Erlangen, Germany
,
Pamela Zengel
5   Department of Otorhinolaryngology, Head-and-Neck-Surgery, University of Munich-Grosshadern Campus, Munich, Germany
,
Heinrich Iro
1   Department of Otorhinolaryngology, Head-and-Neck-Surgery, FAU Medical School Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany
,
Michael Koch
1   Department of Otorhinolaryngology, Head-and-Neck-Surgery, FAU Medical School Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany
› Author Affiliations
Further Information

Publication History

16 July 2018

12 January 2019

Publication Date:
07 February 2019 (online)

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Abstract

Purpose The aim of this study was to assess the interrater reliability of ultrasound for diagnosing sialolithiasis.

Materials and Methods A total of 100 consecutive patients with signs of obstructive sialadenopathy were evaluated. The patients all underwent ultrasound examinations in a standardized manner conducted by one specialist with extensive experience in the management of salivary gland disorders and proficiency in head and neck ultrasonography. The video recordings were sent to six colleagues with comparable experience without providing any further information about the patients’ medical history and physical examination.

Results The overall agreement between the seven observers was substantial, with a κ of 0.765 for the 100 cases and a percentage agreement level of 88.29 ± 3.01 % (range: 83–94 %). The range of agreement on this video set for observer pairs varied from substantial to almost perfect agreement (0.663 to 0.878). Among the few false-negative findings (5.4 %), 71.8 % were due to distal sialolithiasis. Two-thirds of the false-positive findings (3.7 %) were due to fibrotic stenosis.

Conclusion The study confirmed the diagnostic value of ultrasound in sialolithiasis and demonstrated a very high level of interrater agreement, even in the absence of additional clinical patient information, thus further underscoring the importance of ultrasound as the examination of first choice in sialolithiasis.

Zusammenfassung

Ziel Das Ziel dieser Studie war die Beurteilung der Interrater-Reliabilität der Sonografie in der Diagnose der Sialolithiasis.

Material und Methoden Insgesamt wurden 100 konsekutive Patienten mit Anzeichen einer obstruktiven Sialadenopathie untersucht. Die Patienten unterzogen sich einer standardisierten sonografischen Untersuchung, die von einem HNO- Arzt mit umfangreicher Erfahrung in der Sonographie und in der Behandlung von Speicheldrüsenerkrankungen durchgeführt wurde. Die Videoaufnahmen wurden an 6 Kollegen mit vergleichbarer Erfahrung gesendet, ohne weitere Informationen über die Krankengeschichte und die körperliche Untersuchung der Patienten zu geben.

Ergebnisse Die Gesamtübereinstimmung zwischen den 7 Beobachtern war substanziell, mit einem κ von 0,765 für die 100 Fälle und einem prozentualen Übereinstimmungsgrad von 88,29 ± 3,01 % (Bereich 83–94 %). Die Bandbreite der Übereinstimmung in diesem Video-Set für Beobachterpaare variierte von substanziell bis nahezu perfekt (0,663 bis 0,878). Unter den wenigen falsch negativen Befunden (5,4 %) waren 71,8 % auf distale Sialolithiasis zurückzuführen. Zwei Drittel der falsch positiven Befunde (3,7 %) waren auf eine fibrotische Stenose zurückzuführen.

Schlussfolgerung Die Studie bestätigte den diagnostischen Wert von Ultraschall bei Sialolithiasis und zeigte eine sehr hohe Interrater-Übereinstimmung, auch ohne zusätzliche klinische Patienteninformationen. Dies unterstreicht die Bedeutung von Ultraschall für die Untersuchung der ersten Wahl bei Sialolithiasis.

Key words

submandibular - parotid - ultrasound - sialolithiasis - interrater

* These authors contributed equally to the article.


 

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