OSTEOARTHRITIS OF THE FACET JOINTS - ACCURACY OF OBLIQUE RADIOGRAPHIC ASSESSMENT
OSTEOARTHRITIS OF THE FACET JOINTS - ACCURACY OF OBLIQUE RADIOGRAPHIC ASSESSMENT
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DOI：
10.1148/radiology.164.1.3588910
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发表时间：
1987-07-01
期刊：
影响因子：
19.7
通讯作者：
RESNICK, D
中科院分区：
文献类型：
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作者：
PATHRIA, M;SARTORIS, DJ;RESNICK, D
以计算机断层扫描（CT）为标准，评价腰椎X线片对小关节骨性关节炎诊断的敏感性和特异性。两名独立放射科医生使用四分制对50名连续下背部疼痛患者在8个月内获得的斜位X光片和经轴CT扫描的小关节骨关节炎进行盲分级。对L-3至L-4、L-4至L-5和L-5至S-1小关节进行了评估，68%在CT扫描上出现异常，28%表现出中度或重度疾病。常规X线摄影的观察者间一致性较高（完全一致性为57%，一级内一致性为39%），CT的一致性更高（完全一致性为63%，一级内一致性为35%）。受试者工作特征曲线分析表明，斜位X线摄影在区分有无疾病方面最准确（55%的敏感性，69%的特异性）;在区分无疾病或轻度疾病与中度或重度疾病方面，斜位X线摄影的特异性较高，为94%，但其敏感性要低得多，为23%。常规X线摄影是筛查小关节骨关节炎的有用技术，但与CT相比不敏感。
Sensitivity and specificity of lumbar spine radiography in the assessment of facet joint osteoarthritis were evaluated, with computed tomography (CT) as the standard. Two independent radiologists used a four-point scale to blindly grade facet joint osteoarthritis on oblique radiographs and transaxial CT scans obtained within an 8-month period in 50 consecutive patients with pain in the lower back. The L-3 to L-4, L-4 to L-5, and L-5 to S-1 facet joints were evaluated, and 68% appeared abnormal on CT scans, with 28% exhibiting moderate or severe disease. Interobserver agreement was high for conventional radiography (perfect agreement in 57% and agreement to within one grade in 39%) and still higher for CT (perfect in 63% and to within one grade in 35%). Receiver operating characteristic curve analysis indicated that oblique radiography was most accurate (55% sensitivity, 69% specificity) in distinguishing the presence from the absence of disease; in distinguishing absent or mild from moderate or severe disease, the specificity of oblique radiography was higher, at 94%, but its sensitivity was much lower, at 23%. Conventional radiography is a useful technique in screening for facet joint osteoarthritis but is insensitive compared with CT.