Detection of osteoporotic vertebral fractures using multidetector CT
Detection of osteoporotic vertebral fractures using multidetector CT
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DOI：
10.1007/s00198-005-0023-8
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发表时间：
2006-04-01
影响因子：
4
通讯作者：
Link, TM
中科院分区：
文献类型：
--
作者：
Bauer, JS;Müller, D;Link, TM
目的是比较轴向计算机断层扫描（CT）数据集的侧位片和矢状面重建（SR）在识别骨质疏松性椎体骨折中的表现，并评估轴向CT数据集的最佳层厚，以可靠地分类这些骨折。从21具尸体的脊椎中取出65块椎骨，用64排多层CT扫描仪进行检查。获得0.6、1、2、3和5 mm的轴向图像，并利用这些数据集获得SR。此外，标本在前后位和侧位进行x线摄影。四名放射科医生根据脊柱骨折指数（SFI）分类分别对不同图像数据集中显示的椎骨进行分级。通过对所有三个维度的0.6 mm CT数据集进行交互重构的共识读数确定骨折状态，并结合病理检查作为参考标准。每位放射科医生获得的0.6 mm SR与骨折分级参考标准的平均一致性非常好（kappa=0.81）。1-， 2-和3-mm的SR （kappa=0.70, 0.69和0.64）是好的，但对于x线片仅为中等（kappa=0.52），对于5-mm的SR （kappa=0.33）是一般的。当仅关注裂缝检测时，与分级无关，所有kappa值都提高了约0.15,0.6 mm至3 mm SR值优异（0.95）
Goals were to compare the performance of lateral radiographs and sagittal reformations (SR) of axial computed tomography (CT) datasets in identification of osteoporotic vertebral fractures and to assess for optimal slice thickness in axial CT datasets needed for reliable classification of these fractures.Sixty-five vertebrae were harvested from 21 human cadaver spines and examined with a 64-row multidetector CT scanner. Axial images were acquired with a slice thickness of 0.6, 1, 2, 3 and 5 mm and SR were obtained using these datasets. In addition, specimens were radiographed in antero-posterior and lateral orientation. Vertebrae visualized in the different image datasets were separately graded by four radiologists according to the spinal fracture index (SFI) classification. Fracture status determined in a consensus reading of interactive reformations of the 0.6-mm CT dataset in all three dimensions served as a standard of reference in combination with pathological examinations.The average agreement for the 0.6-mm SR obtained between each radiologist and standard of reference for the grading of the fractures was very good (kappa=0.81). It was good for the 1-, 2- and 3-mm SR (kappa=0.70, 0.69 and 0.64), but only moderate for the radiographs (kappa=0.52), and fair for the 5-mm SR (kappa=0.33). When focusing only on detection of fractures, independent of the grading, all kappa values improved by about 0.15, resulting in excellent values for the 0.6-mm through 3-mm SR (0.95