多排 CT 侧位扫描在评估椎体骨折中的可靠性：弗雷明汉骨质疏松研究。
Reliability of vertebral fracture assessment using multidetector CT lateral scout views: the Framingham Osteoporosis Study.
机构信息
Hebrew SeniorLife, Institute for Aging Research Boston, Boston, MA, USA.
出版信息
Osteoporos Int. 2011 Apr;22(4):1123-31. doi: 10.1007/s00198-010-1290-6. Epub 2010 May 21.
UNLABELLED
Two radiologists evaluated images of the spine from computed tomography (CT) scans on two occasions to diagnose vertebral fracture in 100 individuals. Agreement was fair to good for mild fractures, and agreement was good to excellent for more severe fractures. CT scout views are useful to assess vertebral fracture.
INTRODUCTION
We investigated inter-reader agreement between two radiologists and intra-reader agreement between duplicate readings for each radiologist, in assessment of vertebral fracture using a semi-quantitative method from lateral scout views obtained by CT.
METHODS
Participants included 50 women and 50 men (age 50-87 years, mean 70 years) in the Framingham Study. T4-L4 vertebrae were assessed independently by two radiologists on two occasions using a semi-quantitative scale as normal, mild, moderate, or severe fracture.
RESULTS
Vertebra-specific prevalence of grade ≥ 1 (mild) fracture ranged from 3% to 5%. We found fair (κ = 56-59%) inter-reader agreement for grade ≥ 1 vertebral fractures and good (κ = 68-72%) inter-reader agreement for grade ≥ 2 fractures. Intra-reader agreement for grade ≥ 1 vertebral fracture was fair (κ = 55%) for one reader and excellent for another reader (κ = 77%), whereas intra-reader agreement for grade ≥ 2 vertebral fracture was excellent for both readers (κ = 76% and 98%). Thoracic vertebrae were more difficult to evaluate than the lumbar region, and agreement was lowest (inter-reader κ = 43%) for fracture at the upper (T4-T9) thoracic levels and highest (inter-reader κ = 76-78%) for the lumbar spine (L1-L4).
CONCLUSIONS
Based on a semi-quantitative method to classify vertebral fractures using CT scout views, agreement within and between readers was fair to good, with the greatest source of variation occurring for fractures of mild severity and for the upper thoracic region. Agreement was good to excellent for fractures of at least moderate severity. Lateral CT scout views can be useful in clinical research settings to assess vertebral fracture.
未加标签
两位放射科医生在两次检查中评估了来自 CT 扫描的脊柱图像，以诊断 100 名个体的椎骨骨折。对于轻度骨折，一致性为良好到极好，对于更严重的骨折，一致性为极好到优秀。CT 探查视图有助于评估椎骨骨折。
引言
我们研究了两位放射科医生之间的读者间一致性以及每位放射科医生的两次重复阅读之间的读者内一致性，使用 CT 获得的侧位探查视图的半定量方法评估椎骨骨折。
方法
参与者包括弗雷明汉研究中的 50 名女性和 50 名男性（年龄 50-87 岁，平均 70 岁）。T4-L4 椎体由两位放射科医生独立评估两次，使用半定量量表评估为正常、轻度、中度或严重骨折。
结果
特定椎体的 1 级（轻度）骨折患病率为 3%-5%。我们发现，对于 1 级以上的椎骨骨折，读者间的一致性为一般（κ=56-59%），对于 2 级以上的骨折，读者间的一致性为良好（κ=68-72%）。一位读者的 1 级以上椎骨骨折的读者内一致性为一般（κ=55%），另一位读者的读者内一致性为优秀（κ=77%），而对于 2 级以上的椎骨骨折，两位读者的读者内一致性均为优秀（κ=76%和 98%）。胸椎比腰椎更难评估，并且上胸区（T4-T9）骨折的一致性最低（读者间κ=43%），腰椎（L1-L4）的一致性最高（读者间κ=76-78%）。
结论
基于使用 CT 探查视图对椎骨骨折进行分类的半定量方法，读者内和读者间的一致性为一般到良好，最主要的变异源为轻度严重程度的骨折和上胸区骨折。至少中度严重程度的骨折的一致性为良好到优秀。侧位 CT 探查视图可在临床研究环境中用于评估椎骨骨折。
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