Physical Medicine and Rehabilitation Department, University Hospital of Brest, Brest.
Dev Med Child Neurol. 2013 Dec;55(12):1089-102. doi: 10.1111/dmcn.12169. Epub 2013 Jun 4.
The aim of this systematic review was to assess the current validity and reliability of radiological methods used to measure proximal hip geometry in children with cerebral palsy.
A search was conducted using relevant keywords and inclusion/exclusion criteria of the MEDLINE, CINALH Plus, Embase, Web of Science, Academic Search Premier, The Cochrane Library, and PsychINFO databases.
The migration percentage using X-rays showed excellent reliability and concurrent validity with three-dimensional (3D) measurements from computed tomography (CT) scans. The acetabular index, measured using X-rays had good reliability but moderate concurrent validity with 3D CT measurements; 3D CT scan indexes had greater reliability. The measurement of the neck shaft angle using X-rays showed excellent concurrent validity with measurements from 3D CT scans and excellent reliability. Regarding femoral anteversion, one study found an excellent correlation between two-dimensional CT and clinical assessment and excellent reliability. Two others showed less evidence for the use of CT ultrasounds.
Most of the X-ray-based measurements showed good to excellent metrological properties. More metrological evidence is needed for the assessment of femoral anteversion. Magnetic resonance imaging and ultrasound-based measurements have great potential although very little metrological evidence is available.
本系统评价旨在评估目前用于测量脑瘫儿童近端髋关节几何结构的放射学方法的有效性和可靠性。
使用相关的关键词和 MEDLINE、CINALH Plus、Embase、Web of Science、Academic Search Premier、The Cochrane Library 和 PsychINFO 数据库的纳入/排除标准进行了搜索。
使用 X 射线测量的迁移百分比与来自计算机断层扫描 (CT) 扫描的三维 (3D) 测量具有极好的可靠性和一致性。使用 X 射线测量的髋臼指数具有良好的可靠性，但与 3D CT 测量的一致性为中度；3D CT 扫描指标的可靠性更高。X 射线测量的颈干角与来自 3D CT 扫描的测量具有极好的一致性和极好的可靠性。关于股骨前倾角，一项研究发现二维 CT 与临床评估之间具有极好的相关性和极好的可靠性。另外两项研究对 CT 超声的使用提供了较少的证据。
大多数基于 X 射线的测量显示出良好到极好的计量特性。对于股骨前倾角的评估，需要更多的计量学证据。磁共振成像和基于超声的测量具有很大的潜力，尽管可用的计量学证据很少。
