Concordancia entre métodos de diagnóstico por imagem na avalia??o de linfonodomegalias em pacientes HIV(+)/AIDS

摘要

Objective: To assess the percent agreement between diagnostic imaging modalities for the evaluation of lymphadenopathies in HIV-infected/AIDS patients. Materials and Methods: This was an open, comparative, prospective study of diagnostic imaging methods for lymphadenopathy evaluation. We evaluated 30 patients (19 men and 11 women). All underwent ultrasound and computed tomography (CT). Twenty of the patients also underwent magnetic resonance imaging (MRI). We determined the percent agreement between two examiners using the various imaging methods to evaluate lymphadenopathies. Results: CT had the highest percent agreement, at 93.3%, with a kappa coefficient of 0.85, corresponding to 28 of the 30 examinations. When we compared the percent agreement between the two examiners and between CT and ultrasound, examiner 1 had an observed rate of 80.0%, with a kappa of 0.49, corresponding to 24 of the 30 examinations, whereas examiner 2 had a rate of 70.0%, with a kappa of 0.31, corresponding to 21 of the 30 examinations. Between MRI and CT, the percent agreement for examiner 1 was 50.0%, with a kappa of ?0.18, corresponding to 10 of the 20 examinations, whereas that for examiner 2 was 85.0%, with a kappa of 0.69, corresponding to 17 of the 20 examinations. For MRI and ultrasound, examiner 1 had a percent agreement of 70.0%, with a kappa of 0.20, corresponding to 14 of the 20 examinations, and examiner 2 had a percent agreement of 75.0%, with a kappa of 0.38, corresponding to 15 of the 20 examinations. Conclusion: This study indicates that intermethod agreement is highly dependent on the way in which the research is conducted, rather than on the level of experience of the examiner.