Intra- and inter-observer reliability of determining radiographic sagittal parameters of the spine and pelvis using a manual and a computer-assisted methods
Intra- and inter-observer reliability of determining radiographic sagittal parameters of the spine and pelvis using a manual and a computer-assisted methods
复制标题
DOI：
10.1007/s00586-008-0755-1
复制
发表时间：
2008-10-01
影响因子：
2.8
通讯作者：
Roussouly, Pierre
中科院分区：
文献类型：
--
作者：
Dimar, John R., II;Carreon, Leah Y.;Roussouly, Pierre
在决定畸形患者的临床治疗结果时，括约肌失衡是一个重要因素。使用传统的Cobb技术测量矢状面对线经常受到难以可视化标志的阻碍。本报告将传统的手动测量技术与使用半径弧方法的计算机辅助矢状面测量程序进行了比较。计算机程序的观察者内和观察者间可靠性已被证明为0.92-0.99。通过计算机程序对29张90 cm侧位X线片进行矢状面测量。10名经验丰富的骨科脊柱外科医生使用数字卡尺和标准化放射学手册手动测量相同的参数两次，至少间隔48小时。组内相关性被用来确定内部和观察者之间的不同手动措施和手动措施和计算机辅助措施之间的可靠性。手动测量之间的观察者间可靠性较差，不同矢状面测量的范围为-0.02至0.64。人工测量的观察者内可靠性更好，范围为0.40至0.93。将人工测量与计算机辅助测量进行比较，ICC的范围为0.07至0.75。在测量腰椎曲线、胸椎曲线和脊柱-骶骨角时，外科医生之间的一致性比机器之间的一致性更高。除腰椎前凸外，计算机程序的可靠性明显高于其他所有测量值。计算机辅助程序通过消除对清晰可见终板的需要来产生脊柱矢状面的可靠测量。径向弧方法的使用允许沿脊柱沿着使用无限个数据点来确定矢状测量。该技术与数字X线摄影调整图像对比度和亮度的能力相结合，将能够上级地识别传统X线摄影通常无法测量的关键解剖参数，提高矢状面测量的一致性。
Sagittal imbalance is a significant factor in determining clinical treatment outcomes in patients with deformity. Measurement of sagittal alignment using the traditional Cobb technique is frequently hampered by difficulty in visualizing landmarks. This report compares traditional manual measurement techniques to a computer-assisted sagittal plane measurement program which uses a radius arc methodology. The intra and inter-observer reliability of the computer program has been shown to be 0.92-0.99. Twenty-nine lateral 90 cm radiographs were measured by a computer program for an array of sagittal plane measurements. Ten experienced orthopedic spine surgeons manually measured the same parameters twice, at least 48 h apart, using a digital caliper and a standardized radiographic manual. Intraclass correlations were used to determine intra- and interobserver reliability between different manual measures and between manual measures and computer assisted-measures. The inter-observer reliability between manual measures was poor, ranging from -0.02 to 0.64 for the different sagittal measures. The intra-observer reliability in manual measures was better ranging from 0.40 to 0.93. Comparing manual to computer-assisted measures, the ICC ranged from 0.07 to 0.75. Surgeons agreed more often with each other than with the machine when measuring the lumbar curve, the thoracic curve, and the spino-sacral angle. The reliability of the computer program is significantly higher for all measures except for lumbar lordosis. A computer-assisted program produces a reliable measurement of the sagittal profile of the spine by eliminating the need for distinctly visible endplates. The use of a radial arc methodology allows for infinite data points to be used along the spine to determine sagittal measurements. The integration of this technique with digital radiography's ability to adjust image contrast and brightness will enable the superior identification of key anatomical parameters normally not available for measurement on traditional radiographs, improving the consistency of sagittal measurement.