Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Osteoporos Int. 2011 Oct;22(10):2677-88. doi: 10.1007/s00198-011-1530-4. Epub 2011 Jan 27.
Intra-and inter-reader reliability of semi-automated quantitative vertebral morphometry measurements was determined using lateral computed tomography (CT) scout views. The method requires less time than conventional morphometry. Reliability was excellent for vertebral height measurements, good for height ratios, and comparable to semi-quantitative grading by radiologists for identification of vertebral fractures.
Underdiagnosis and undertreatment of vertebral fracture (VFx) is a well-known problem worldwide. Thus, new methods are needed to facilitate identification of VFx. This study aimed to determine intra- and inter-reader reliability of semi-automated quantitative vertebral morphometry based on shape-based statistical modeling (SpineAnalyzer, Optasia Medical, Cheadle, UK).
Two non-radiologists independently assessed vertebral morphometry from CT lateral scout views at two time points in 96 subjects (50 men, 46 women, 70.3 ± 8.9 years) selected from the Framingham Heart Study Offspring and Third Generation Multi-Detector CT Study. VFxs were classified based solely on morphometry measurements using Genant's criteria. Intraclass correlation coefficients (ICCs), root mean squared coefficient of variation (RMS CV) and kappa (k) statistics were used to assess reliability.
We analyzed 1,246 vertebrae in 96 subjects. The analysis time averaged 5.4 ± 1.7 min per subject (range, 3.2-9.1 min). Intra-and inter-reader ICCs for vertebral heights were excellent (>0.95) for all vertebral levels combined. Intra-and inter-reader RMS CV for height measurements ranged from 2.5% to 3.9% and 3.3% to 4.4%, respectively. Reliability of vertebral height ratios was good to fair. Based on morphometry measurements alone, readers A and B identified 51-52 and 46-59 subjects with at least one prevalent VFx, respectively, and there was a good intra-and inter-reader agreement (k = 0.59-0.69) for VFx identification.
Semi-automated quantitative vertebral morphometry measurements from CT lateral scout views are convenient and reproducible, and may facilitate assessment of VFx.
使用侧位计算机断层扫描 (CT) 扫描图来确定半自动定量椎体形态计量测量的内-间读者可靠性。该方法比传统形态计量学所需的时间更少。椎体高度测量的可靠性极好，高度比的可靠性良好，与放射科医生对椎体骨折的半定量分级相当，有助于识别椎体骨折。
椎体骨折 (VFx) 的漏诊和治疗不足是一个众所周知的全球性问题。因此，需要新的方法来方便识别 VFx。本研究旨在使用基于形状的统计建模（SpineAnalyzer，Optasia Medical，英国柴郡）确定半自动定量椎体形态计量的内-间读者可靠性。
从Framingham Heart Study 后代和第三代多探测器 CT 研究中选择的 96 名受试者（50 名男性，46 名女性，70.3±8.9 岁）的 CT 侧位扫描图中，由两名非放射科医生独立评估椎体形态计量。使用 Genant 的标准仅根据形态计量测量结果对 VFx 进行分类。使用组内相关系数 (ICC)、均方根变异系数 (RMS CV) 和 kappa (k) 统计来评估可靠性。
我们分析了 96 名受试者的 1246 个椎体。分析时间平均为每位受试者 5.4±1.7 分钟（范围为 3.2-9.1 分钟）。所有椎体水平的椎体高度的内-间读者 ICC 均极好（>0.95）。椎体高度测量的内-间读者 RMS CV 范围分别为 2.5%至 3.9%和 3.3%至 4.4%。椎体高度比的可靠性为好至一般。仅根据形态计量测量结果，读者 A 和 B 分别识别出 51-52 名和 46-59 名至少有一处 VFx 的受试者，并且 VFx 识别的内-间读者一致性良好（k=0.59-0.69）。
从 CT 侧位扫描图半自动定量椎体形态计量测量既方便又可重复，可能有助于评估 VFx。
