Hercock C A, Innes J F, McConnell F, Guilliard M J, Ness M G, Hodson D, Young I S
Musculoskeletal Reserach Group, The University of Liverpool, School of Veterinary Science, Liverpool, United Kingdom.
Vet Comp Orthop Traumatol. 2011;24(3):215-22. doi: 10.3415/VCOT-10-06-0085. Epub 2011 Mar 3.
To determine observer agreement on radiographic evaluation of central tarsal bone (CTB) fractures and compare this with evaluation of the same fractures using computed tomography (CT).
Radiographs and CT scans were obtained of the right tarsi from limbs of Greyhounds euthanatized after sustaining severe CTB fracture during racing. Four observers described and classified each fracture. Inter- and intra-observer agreements were calculated.
Inter-observer agreement was higher for assessment of fractures using CT. Several fractures assessed by radiography were misclassified as a less severe type. Intra-observer agreement for assessment and classification of CTB fractures via radiography versus CT was variable. Overall agreement among all four observers was higher for CT than radiography. Additionally, when identifying fractures of the adjacent tarsal bones, observer agreement was higher for CT than radiography.
Computed tomography improved observer ability to correctly evaluate CTB fracture and detect the degree of displacement and extent of any comminution. Identification of fractures of adjacent tarsal bones was also improved when tarsi were assessed using CT. These data suggest that treatment decisions based solely on radiographic assessment of CTB fractures may not produce the expected outcome.
确定观察者对跗中骨（CTB）骨折影像学评估的一致性，并将其与使用计算机断层扫描（CT）对相同骨折的评估进行比较。
从赛犬比赛中遭受严重CTB骨折后安乐死的肢体获取右跗骨的X线片和CT扫描图像。四名观察者对每个骨折进行描述和分类。计算观察者间和观察者内的一致性。
使用CT评估骨折时观察者间的一致性更高。通过X线片评估的一些骨折被错误分类为较轻的类型。通过X线片与CT对CTB骨折进行评估和分类的观察者内一致性各不相同。所有四名观察者之间对CT的总体一致性高于X线片。此外，在识别相邻跗骨的骨折时，CT的观察者一致性高于X线片。
计算机断层扫描提高了观察者正确评估CTB骨折以及检测移位程度和任何粉碎范围的能力。使用CT评估跗骨时，对相邻跗骨骨折的识别也得到了改善。这些数据表明，仅基于CTB骨折的X线片评估做出的治疗决策可能无法产生预期的结果。
