Reliability of clinically relevant 3D foot bone angles from quantitative computed tomography.
Reliability of clinically relevant 3D foot bone angles from quantitative computed tomography.
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DOI：
10.1186/1757-1146-6-38
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发表时间：
2013-09-17
影响因子：
2.9
通讯作者：
Sinacore DR
中科院分区：
文献类型：
--
作者：
Gutekunst DJ;Liu L;Ju T;Prior FW;Sinacore DR
足部病理的外科治疗和临床管理需要对足部畸形进行准确、可靠的评估。足部和踝关节畸形是多平面的，因此很难通过标准x线片进行量化。三维（3D）成像模式已被用于基于骨形状的惯性轴来定义骨方向，但这些惯性轴无法模仿骨科和临床生物力学中使用的既定骨角度。为了提高三维骨角度的临床相关性，我们开发了使用定量计算机断层扫描（QCT）骨表面网格上的地标来定义骨轴的技术。我们的目的是评估基于地标的测量精度，为专家评分者和基于模板的自动化方法评估后足和小跗骨的三维骨对骨方向。两名评分者完成了20英尺（10右，10左）的两次重复，在跟骨、距骨、长方体和舟骨表面放置解剖标志。地标也被记录使用自动化的，基于模板的方法。对于每种方法，从地标位置计算三维骨轴，Cardan序列产生骨与骨方向的矢状面、正面和横切面角。角信度的评估采用类内相关系数（ICCs）和类内和类间精度的均方根标准差（RMS-SD），以及类内和类间一致性与自动一致性。评分内和评分间的ICCs普遍较高（≥0.80），与自动化方法相比，每个评分者的ICCs也同样高。两种评分器的RMS-SD内评分精度分别为1.4 ~ 3.6°和2.4 ~ 6.1°，优于单平面x线摄影精度。变异最大的是舟骨：距骨矢状面角和长方体：跟骨额面角。自动化的、基于图谱的模板方法相对于评分者的精度与每个评分者的内部精度相当。内部和内部精度表明，基于地标的方法具有足够的测试-重测试可靠性，用于足部畸形的三维评估。基于图谱的自动化方法与专家评分者的一致表明，自动化方法是一种有效的、节省时间的足部畸形评估技术。这些方法有可能通过允许多平面量化畸形来改善足部和踝关节病变的诊断。
Surgical treatment and clinical management of foot pathology requires accurate, reliable assessment of foot deformities. Foot and ankle deformities are multi-planar and therefore difficult to quantify by standard radiographs. Three-dimensional (3D) imaging modalities have been used to define bone orientations using inertial axes based on bone shape, but these inertial axes can fail to mimic established bone angles used in orthopaedics and clinical biomechanics. To provide improved clinical relevance of 3D bone angles, we developed techniques to define bone axes using landmarks on quantitative computed tomography (QCT) bone surface meshes. We aimed to assess measurement precision of landmark-based, 3D bone-to-bone orientations of hind foot and lesser tarsal bones for expert raters and a template-based automated method. Two raters completed two repetitions each for twenty feet (10 right, 10 left), placing anatomic landmarks on the surfaces of calcaneus, talus, cuboid, and navicular. Landmarks were also recorded using the automated, template-based method. For each method, 3D bone axes were computed from landmark positions, and Cardan sequences produced sagittal, frontal, and transverse plane angles of bone-to-bone orientations. Angular reliability was assessed using intraclass correlation coefficients (ICCs) and the root mean square standard deviation (RMS-SD) for intra-rater and inter-rater precision, and rater versus automated agreement. Intra- and inter-rater ICCs were generally high (≥ 0.80), and the ICCs for each rater compared to the automated method were similarly high. RMS-SD intra-rater precision ranged from 1.4 to 3.6° and 2.4 to 6.1°, respectively, for the two raters, which compares favorably to uni-planar radiographic precision. Greatest variability was in Navicular: Talus sagittal plane angle and Cuboid: Calcaneus frontal plane angle. Precision of the automated, atlas-based template method versus the raters was comparable to each rater’s internal precision. Intra- and inter-rater precision suggest that the landmark-based methods have adequate test-retest reliability for 3D assessment of foot deformities. Agreement of the automated, atlas-based method with the expert raters suggests that the automated method is a valid, time-saving technique for foot deformity assessment. These methods have the potential to improve diagnosis of foot and ankle pathologies by allowing multi-planar quantification of deformities.
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影响因子：
2.9
作者：
Nester CJ
通讯作者：
Nester CJ
影响因子：
2.7
作者：
Schon, LC;Weinfeld, SB;Resch, S
通讯作者：
Resch, S
影响因子：
2.4
作者：
Brown, Kathryn M.;Bursey, Diane E.;Glasoe, Ward M.
通讯作者：
Glasoe, Ward M.
影响因子：
2.7
作者：
Hastings MK;Sinacore DR;Mercer-Bolton N;McCormick JJ;Hildebolt CF;Prior FW;Johnson JE
通讯作者：
Johnson JE
影响因子：
2.4
作者：
Stebbins, J;Harrington, A;Theologis, T
通讯作者：
Theologis, T