Street John, Lenehan Brian, Albietz John, Bishop Paul, Dvorak Marcel, Fisher Charles
Combined Neurosurgical and Orthopedic Spine Program, Vancouver Hospitals and Health Sciences Center, 2733 Heather Street, Vancouver, British Columbia V5Z 3J5, Canada.
Spine J. 2009 Jun;9(6):464-9. doi: 10.1016/j.spinee.2009.02.007. Epub 2009 Apr 8.
Consensus documents have recently been developed enumerating the radiographic parameters thought to be most valid in the clinical evaluation of patients with thoracolumbar fractures.
The objective of this study was to assess the measurement reliability of plain X-rays, computed tomography (CT), and magnetic resonance imaging (MRI) and their inter-modality agreement, as the three imaging modalities are often clinically interchangeable. This process is an essential reliability evaluation of the measurement parameters being proposed.
This study evaluated the interobserver and intraobserver reliability of plain radiographs, CT, and MRI measurements of sagittal kyphosis in thoracolumbar fractures.
Suitable plain X-ray, CT, and MRI radiographic imaging of ten cases of thoracolumbar fracture were examined.
Suitable plain X-ray, CT, and MRI radiographic imaging of ten cases of thoracolumbar fracture were examined by ten independent spine surgery fellowship-trained observers.
Cobb angle measurement, Gardner segmental deformity angle, and anterior body compression percentage were measured.
Regardless of the imaging modality or the parameter being measured, the intraobserver reliability is always better than the interobserver. Plain radiography has better overall, interobserver and intraobserver reliability, followed by CT and then MRI. Reliability is very high in general, with the highest reliability for intraobserver reliability of the linear measures on plain radiographs. The inter-modality agreement is highest for plain X-ray and CT.
This study demonstrates that Cobb angle measurement, Gardner segmental deformity angle, and anterior body compression percentage are reliable measures of thoracolumbar fracture kyphosis with very high interobserver and intraobserver reliability and very high inter-modality agreement of plain X-ray with CT.
最近已制定共识文件，列举了在胸腰椎骨折患者临床评估中被认为最有效的影像学参数。
本研究的目的是评估普通X线、计算机断层扫描（CT）和磁共振成像（MRI）的测量可靠性及其不同模态之间的一致性，因为这三种成像模态在临床上常常可相互替代。此过程是对所提出测量参数的一项重要可靠性评估。
本研究评估了胸腰椎骨折矢状面后凸畸形的普通X线片、CT和MRI测量的观察者间及观察者内可靠性。
对10例胸腰椎骨折的合适普通X线、CT和MRI影像学检查进行了分析。
由10名接受过脊柱外科专科培训的独立观察者对10例胸腰椎骨折的合适普通X线、CT和MRI影像学检查进行评估。
测量Cobb角、加德纳节段畸形角和椎体前缘压缩百分比。
无论成像模态或所测量的参数如何，观察者内可靠性始终优于观察者间可靠性。普通X线摄影总体、观察者间和观察者内可靠性更好，其次是CT，然后是MRI。一般来说可靠性非常高，普通X线片上线形测量的观察者内可靠性最高。普通X线与CT之间的不同模态一致性最高。
本研究表明，Cobb角测量、加德纳节段畸形角和椎体前缘压缩百分比是胸腰椎骨折后凸畸形的可靠测量指标，具有非常高的观察者间和观察者内可靠性，以及普通X线与CT之间非常高的不同模态一致性。
