title: Intrarater reliability in the ultrasound diagnosis of medial and lateral orbital wall fractures with a curved array transducer.
abstract: OBJECTIVE
  The aims of the study were to document the effectiveness of ultrasound (US) in diagnosing orbital wall fractures when compared with computed tomography (CT) and to measure the intraobserver reliability of US using a curved array transducer.
  
  
  METHODS
  From December 2003 to March 2004, 13 patients with the clinical diagnosis of an orbital trauma were investigated prospectively by CT (reference) and 2 US investigators. Both orbits were investigated. Sensitivity, specificity, accuracy, and positive and negative predictive value were calculated. The statistical difference between the 2 US investigators was calculated by a chi-square test. The interrater reliability was calculated using the lambda coefficient. Values below 0.4 represent poor reliability, between 0.4 and 0.75 represent fair to good reliability, and a score > 0.75 is graded as excellent reliability.
  
  
  RESULTS
  The comparison of the results of the 2 US investigators by the chi-square test showed P values of .385 for the medial orbital wall and .638 for the lateral orbital wall, which shows no significant difference. The lambda-value for the investigation of the medial orbital wall reached 0.429, 0.714, and 0.750. The lambda-value for the investigation of the lateral orbital wall yielded 0.647, 0.750, and 0.882. These values show a good and excellent inter-rater reliability.
  
  
  CONCLUSIONS
  The US investigation does not yet reach the diagnostic quality of CT. US could be a helpful diagnostic imaging tool in cases with clear clinical symptoms. The results of the current study and the previously published results imply that US has the potential to reach the same diagnostic quality as CT in the future, but further studies must be performed to improve the diagnostic quality of the method.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Innsbruck, Germany. siegfried.jank@gmx.de
authors.forename: Siegfried
authors.initials: S
authors.lastname: Jank
authors.forename: Martina
authors.initials: M
authors.lastname: Deibl
authors.forename: Heinrich
authors.initials: H
authors.lastname: Strobl
authors.forename: Andreas
authors.initials: A
authors.lastname: Oberrauch
authors.forename: Alessandro
authors.initials: A
authors.lastname: Nicasi
authors.forename: Martin
authors.initials: M
authors.lastname: Missmann
authors.forename: Gerd
authors.initials: G
authors.lastname: Bodner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009915:Orbit / Q000000981:diagnostic imaging; D009917:Orbital Fractures / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014159:Transducers; D014463:Ultrasonography