Tibial Stress Injury: Relationship of Radiographic, Nuclear Medicine Bone Scanning, MR Imaging, and CT Severity Grades to Clinical Severity and Time to Healing
Tibial Stress Injury: Relationship of Radiographic, Nuclear Medicine Bone Scanning, MR Imaging, and CT Severity Grades to Clinical Severity and Time to Healing
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DOI：
10.1148/radiol.12102426
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发表时间：
2012-06-01
期刊：
影响因子：
19.7
通讯作者：
Marcus, Robert
中科院分区：
文献类型：
--
作者：
Beck, Belinda R.;Bergman, A. Gabrielle;Marcus, Robert
目的：研究放射学严重程度分级、~(99m)Cs三相核医学骨扫描、磁共振(MR)和计算机断层扫描(CT)、临床严重程度和胫骨应力性损伤(TSI)恢复时间之间的关系，以及评估人员间分级的可靠性。材料和方法：该方案由格里菲斯大学人类研究伦理委员会、斯坦福大学人类医学研究小组、美国陆军人类研究审查委员会和澳大利亚国防人类研究伦理委员会批准。所有受试者均获得知情同意。入选40名TSI受试者(男性17名，女性23名；平均年龄26.2岁+/-6.9[标准差])。受试者接受标准的正位和侧位X线片、核医学扫描、磁共振成像和CT检查。每种模式都由四名盲目的临床医生进行评分。混合效应模型被用来检验图像严重性、临床严重性和愈合时间之间的关系，并对图像形态和评估者进行了调整。结果：除放射学评分信度为中等(α=0.565~0.895)外，其余评分系统均具有较高的评分信度。临床严重程度与磁共振成像严重程度呈负相关(P<；.001)。TSI临床严重程度与MR严重程度呈负相关(P=.07)，但愈合时间与严重程度评分之间无显著相关性。X线片、骨扫描和CT严重程度与愈合时间无关，但磁共振成像有积极的趋势。(C)RSNA，2012年
Purpose: To examine the relationship between severity grade for radiography, triple-phase technetium 99m nuclear medicine bone scanning, magnetic resonance (MR) imaging, and computed tomography (CT); clinical severity; and recovery time from a tibial stress injury (TSI), as well as to evaluate interassessor grading reliability.Materials and Methods: This protocol was approved by the Griffith University Human Research Ethics Committee, the Stanford University Panel on Human Subjects in Medical Research, the U.S. Army Human Subjects Research Review Board, and the Australian Defense Human Research Ethics Committee. Informed consent was obtained from all subjects. Forty subjects (17 men, 23 women; mean age, 26.2 years +/- 6.9 [standard deviation]) with TSI were enrolled. Subjects were examined acutely with standard anteroposterior and lateral radiography, nuclear medicine scanning, MR imaging, and CT. Each modality was graded by four blinded clinicians. Mixed-effects models were used to examine associations between image severity, clinical severity, and time to healing, with adjustments for image modality and assessor. Grading reliability was evaluated with the Cronbach alpha coefficient.Results: Image assessment reliability was high for all grading systems except radiography, which was moderate (alpha = 0.565-0.895). Clinical severity was negatively associated with MR imaging severity (P < .001). There was no significant relationship between time to healing and severity score for any imaging modality, although a positive trend existed for MR imaging (P = .07).Conclusion: TSI clinical severity was negatively related to MR imaging severity. Radiographic, bone scan, and CT severity were not related to time to healing, but there was a positive trend for MR imaging. (c) RSNA, 2012