Shon Won Yong, Gupta Siddhartha, Biswal Sandeep, Han Sang Hwan, Hong Suk Joo, Moon Jun Gyu
Department of Orthopedics, Korea University Guro Hospital, Seoul, Korea.
J Arthroplasty. 2009 Aug;24(5):743-50. doi: 10.1016/j.arth.2008.02.012. Epub 2008 Jun 13.
The relationship of radiographic pelvic osteolysis to computed tomographic (CT) volume and polyethylene wear remains controversial. We evaluated the sensitivity and specificity of radiographs in detecting osteolysis considering CT scan as the true value, in 118 hips with cementless cups. Correlation between osteolysis volume in CT, area of osteolysis in radiograph, and linear wear of polyethylene was assessed. The sensitivity and specificity of anteroposterior radiographs for detection of osteolysis was 57.6% and 92.9%, respectively. Addition of oblique radiographs increased the sensitivity to 64.4% without changing the specificity. The sensitivity increased to 92.8% for lesion more than 1000 mm(3). There was good correlation between 2-dimensional (2D) osteolytic area in radiograph and 3-dimensional (3D) volume (r = 0.74) in CT scan and linear wear of polyethylene showed good correlation with 3D CT volume (r = 0.62) and 2D area in radiograph (r = 0.60). Thus radiographs are useful to screen clinically significant osteolysis.
骨盆X线骨质溶解与计算机断层扫描（CT）体积及聚乙烯磨损之间的关系仍存在争议。在118例使用非骨水泥髋臼杯的髋关节中，我们将CT扫描视为真值，评估了X线片检测骨质溶解的敏感性和特异性。评估了CT中的骨质溶解体积、X线片上的骨质溶解面积与聚乙烯线性磨损之间的相关性。前后位X线片检测骨质溶解的敏感性和特异性分别为57.6%和92.9%。增加斜位X线片可将敏感性提高至64.4%，而特异性不变。对于大于1000 mm³ 的病变，敏感性增至92.8%。X线片上的二维（2D）骨质溶解面积与CT扫描中的三维（3D）体积之间存在良好相关性（r = 0.74），聚乙烯的线性磨损与3D CT体积（r = 0.62）及X线片上的2D面积（r = 0.60）均显示出良好相关性。因此，X线片对于筛查具有临床意义的骨质溶解很有用。
