Evaluation of Different Methods for Measuring Lateral Tibial Slope Using Magnetic Resonance Imaging
Evaluation of Different Methods for Measuring Lateral Tibial Slope Using Magnetic Resonance Imaging
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DOI：
10.1177/0363546512461749
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发表时间：
2012-12-01
影响因子：
4.8
通讯作者：
Wojtys, Edward M.
中科院分区：
文献类型：
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作者：
Lipps, David B.;Wilson, Annie M.;Wojtys, Edward M.
背景：由于胫骨外侧斜度(LTS)在动态动作中会影响胫骨前移位和前交叉韧带(ACL)的拉伤程度，因此准确测量LTS可能有助于筛查前交叉韧带损伤的高危人群。在胫骨近端的磁共振成像(MRI)扫描上测量LTS的方法包括中点法和圆法。目前还没有研究验证不同的胫骨近端MRI扫描测量LTS的方法。假设：(1)LTS测量与使用中点方法成像的胫骨长度无关，(2)不同方法(中点、圆形和全胫骨)计算的LTS测量没有显著差异。研究设计：对照实验室研究。方法：盲法观察者测量3-Tesla的LTS，40例大小匹配的供者按1圆法和3中点法测量LTS。然后将结果与11名捐赠者的全胫骨解剖轴(连接胫骨近端和远端两个圆的中心的连线)进行比较。采用Bonferroni校正配对t检验(P&t；.005)对5种方法进行比较。结果：圆法和全胫法的观察者间和观察者内变异最小，而胫骨10 cm的中点法变异最大。胫骨近端10 cm和15 cm的中点测量法与胫骨全解剖轴的LTS测量非常相似。结论：虽然中点法测量LTS与全胫骨测量相似，但中点法的可靠性取决于所用胫骨近端的长度。圆法可能是未来研究的首选方法，因为它是重复性最好的方法，而且不受胫骨近端长度的影响。
Background: Since lateral tibial slope (LTS) affects the amount of anterior tibial translation and anterior cruciate ligament (ACL) strain during a dynamic maneuver, accurate measurements of LTS may be beneficial in screening people at a higher risk for ACL injury. Methods for measuring LTS on magnetic resonance imaging (MRI) scans of the proximal tibia include the midpoint and circle methods. No current studies have validated different LTS measurement methods using a proximal tibia MRI scan.Hypothesis: We tested the null hypotheses that (1) LTS measurements were independent of the length of tibia imaged using the midpoint method, and (2) LTS measurements calculated from different methods (midpoint, circle, and full tibia) would not differ significantly.Study Design: Controlled laboratory study.Methods: Blinded observers measured LTS from 3-tesla, 3-dimensional MRIs from 40 size-matched donors according to 1 circle method and 3 midpoint methods. Outcomes were then compared with the full-tibial anatomic axis (line connecting the center of 2 circles fit within the proximal and distal tibia) in 11 donors. Bonferroni-corrected paired t tests (significance, P < .005) were used to compare the 5 methods.Results: The circle and full-tibia methods had the lowest interobserver and intraobserver variability, whereas the midpoint method with 10-cm tibia was the most variable. The midpoint method with 10-cm and 15-cm proximal tibia closely resembled LTS measurements with the full-tibial anatomic axis. The circle method, although repeatable, provided smaller numerical LTS measurements than the full-tibia and midpoint methods.Conclusion: Although LTS measurements using the midpoint method can resemble measurements made using the full tibia, the reliability of the midpoint method depends on the length of proximal tibia used. The circle method may be the preferred method for future studies since it was the most repeatable method and is independent of proximal tibial length.