Measurement of vertebral rotation in adolescent idiopathic scoliosis with low-dose CT in prone position - method description and reliability analysis.
Measurement of vertebral rotation in adolescent idiopathic scoliosis with low-dose CT in prone position - method description and reliability analysis.
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DOI：
10.1186/1748-7161-5-4
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发表时间：
2010-02-23
期刊：
影响因子：
--
通讯作者：
Ohlin A
中科院分区：
文献类型：
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作者：
Abul-Kasim K;Karlsson MK;Hasserius R;Ohlin A
据我们所知，文献中没有关于俯卧位低剂量计算机断层扫描（CT）测量椎体旋转的报道。为了描述和测试这种新方法的可靠性，将其与其他正在使用的方法进行比较，并评估身体位置对不同放射学方法测量的椎体旋转程度的影响。回顾性研究。本研究的分析中纳入了连续 25 名计划接受手术的青少年特发性脊柱侧凸患者（17 名女孩，8 名男孩），年龄为 15 ± 2 岁（平均值 ± 标准差）。所有患者的椎体旋转程度均按照 Perdriolle 方法在站立位平片和仰卧位 CT 扫描图像上测量，并在俯卧位轴向 CT 图像和仰卧位磁共振成像 (MRI) 上按照 Aaro 和 Dahlborn 方法测量。这些测量是由一名神经放射科医生在两个不同的场合进行的。 Bland 和 Altman 统计方法用于可靠性评估。俯卧位轴向CT图像测量椎体旋转的可靠性几乎完美，组内相关系数为0.95，观察者内差异的随机误差为2.3°，重复性系数为3.2°，变异系数为18.4%。 CT扫描图测量值的相应值分别为0.83、5.1°、7.2°和32.8%，表明后一种方式和方法的可靠性较低。站立位X线平片、俯卧位CT扫描图、俯卧位CT轴向图像和仰卧位MRI轴位图像测量的椎体旋转角度分别为25.7±9.8°、21.9±8.3°、17.4±7.1°和16.1±6.5°。俯卧位轴向 CT 图像测量的椎体旋转量比仰卧位轴向 MRI 测量的椎体旋转量平均大 7.5%。这项研究表明，俯卧位椎体旋转的测量在轴向 CT 图像上比在 CT 扫描图像上更可靠。与仰卧位 MRI 相比，俯卧位 CT 上的椎体旋转测量（校正骨盆倾斜）与仰卧位 MRI 相比，卧位对椎体旋转的影响较小。然而，差异的大小具有令人怀疑的临床意义。
To our knowledge there is no report in the literature on measurements of vertebral rotation with low-dose computed tomography (CT) in prone position. To describe and test the reliability of this new method, compare it with other methods in use and evaluate the influence of body position on the degree of vertebral rotation measured by different radiological methods. Retrospective study. 25 consecutive patients with adolescent idiopathic scoliosis scheduled for surgery (17 girls, 8 boys) aged 15 ± 2 years (mean ± SD) were included in the analysis of this study. The degree of the vertebral rotation was in all patients measured according to the method of Perdriolle on standing plain radiographs and on supine CT scanogram, and according to the method of Aaro and Dahlborn on axial CT images in prone position and on magnetic resonance imaging (MRI) in supine position. The measurements were done by one neuroradiologist at two different occasions. Bland and Altman statistical approach was used in the reliability assessment. The reliability of measuring vertebral rotation by axial CT images in prone position was almost perfect with an intraclass correlation coefficient of 0.95, a random error of the intraobserver differences of 2.3°, a repeatability coefficient of 3.2° and a coefficient of variation of 18.4%. Corresponding values for measurements on CT scanogram were 0.83, 5.1°, 7.2°, and 32.8%, respectively, indicating lower reliability of the latter modality and method. The degree of vertebral rotation measured on standing plain radiographs, prone CT scanogram, axial images on CT in prone position and on MRI in supine position were 25.7 ± 9.8°, 21.9 ± 8.3°, 17.4 ± 7.1°, and 16.1 ± 6.5°, respectively. The vertebral rotation measured on axial CT images in prone position was in average 7.5% larger than that measured on axial MRI in supine position. This study has shown that measurements of vertebral rotation in prone position were more reliable on axial CT images than on CT scanogram. The measurement of vertebral rotation on CT (corrected to the pelvic tilt) in prone position imposes lower impact of the recumbent position on the vertebral rotation than did MRI in supine position. However, the magnitude of differences is of doubtful clinical significance.