Polet K, de La Selle H, Leroux J, Ludig T, Girard F, Coudane H, Blum A
Service d'imagerie Guilloz, Hôpital Central, 54035 Nancy-cedex.
J Radiol. 2003 Mar;84(3):299-303.
Digital radiography may lead to interpretation difficulties in patients with hip prosthesis, especially when initial evaluation was performed using screen film radiography. The purpose of this study was to evaluate inter-observer and inter-technique reproducibility comparing digital and screen-film radiography.
Twenty-eight patients with unilateral (n=24) or bilateral (n=4) hip prosthesis (total=32 prostheses) underwent screen-film and digital (storage phosphor) radiography. The bone-cement and metal-cement interfaces were evaluated for the presence of a lucent line in 14 different sectors reclassified into 3 regions. This evaluation was performed by two independent readers. Inter-observer and inter-technique reproducibility were calculated using kappa values.
The inter-observer reproducibility was negligible, poor or average with Kappa values ranging from 0.07 to 0.47. The degree of agreement between the two methods was poor, average or good for both observers with Kappa values ranging from 0.10 to 0.66.
Although inter-technique agreement is not high, it is better than inter-observer agreement. Therefore, storage phosphor technique should not be rejected for total hip prosthesis follow-up, even though previous films were screen-film radiographs.
数字X线摄影可能会给髋关节置换患者的影像解读带来困难,尤其是当初次评估采用屏-片X线摄影时。本研究的目的是比较数字X线摄影和屏-片X线摄影,评估观察者间及技术间的可重复性。
28例单侧(n = 24)或双侧(n = 4)髋关节置换患者(共32个假体)接受了屏-片和数字(存储磷光体)X线摄影。对骨水泥和金属-水泥界面进行评估,观察14个不同扇区(重新划分为3个区域)中是否存在透亮线。该评估由两名独立的阅片者进行。使用kappa值计算观察者间及技术间的可重复性。
观察者间的可重复性可忽略不计、较差或中等,kappa值范围为0.07至0.47。两种方法之间的一致性程度对两名观察者而言均为较差、中等或良好,kappa值范围为0.10至0.66。
尽管技术间的一致性不高,但优于观察者间的一致性。因此,即使之前的影像为屏-片X线摄影,存储磷光体技术也不应被排除在全髋关节置换随访之外。