Young Michelle, Hill Douglas L, Zheng Rui, Lou Edmond
Department of Surgery, University of Alberta, 8440 - 112 Street, Edmonton, AB, T6G 2B7, Canada.
Eur Spine J. 2015 Jul;24(7):1427-33. doi: 10.1007/s00586-015-3855-8. Epub 2015 Mar 10.
The objectives of this preliminary study were to assess the reliability and accuracy of ultrasound (US) for measuring coronal curvature with and without the aid of a previous radiograph, and to evaluate the ability of US to detect curve progression in adolescent idiopathic scoliosis (AIS) patients.
Four raters measured 20 AIS US images twice at one-week intervals. Intra-rater reliability and correlation with radiograph were investigated with (rater 1) and without (raters 2-4) the aid of a previous radiograph. The center of lamina (COL) method was used to approximate the Cobb angle.
Thirty-six curves were identified. All raters showed high intra-rater reliability (ICC[2,1] >0.80). With the aid of a previous radiograph, rater 1 showed higher correlation with radiograph (ICC[2,1] = 0.86), better standard error of measurement (SEM = 2.2°), and improved error index of selecting end-vertebrae (EI = 1.34), but no statistical improvement of intra-rater reliability (p > 0.05). For rater 2-4, the range of the ICC[2,1] values between US and radiograph measurements, the SEM value, and the range of the EI values were 0.70°-0.72°, 3.3°, and 1.65°-2.36°, respectively. Specificity and sensitivity of US for detecting curve progression were 0.91 and 0.83, respectively.
Using a previous radiograph as a measurement aid helped the user to measure coronal curvature from US images, and improved the accuracy of end-vertebrae selection. US showed high sensitivity and specificity for detecting curve progression, indicating that US may be a suitable, radiation-free alternative for monitoring patients with AIS who have mild or moderate curves.
本初步研究的目的是评估在有或没有先前X线片辅助的情况下，超声（US）测量冠状面弯曲度的可靠性和准确性，并评估US检测青少年特发性脊柱侧凸（AIS）患者曲线进展的能力。
四名评估者每隔一周对20张AIS的US图像进行两次测量。在有（评估者1）和没有（评估者2 - 4）先前X线片辅助的情况下，研究评估者内部可靠性以及与X线片的相关性。使用椎板中心（COL）方法近似Cobb角。
共识别出36条曲线。所有评估者均显示出较高的评估者内部可靠性（组内相关系数ICC[2,1]>0.80）。在先前X线片的辅助下，评估者1与X线片的相关性更高（ICC[2,1]=0.86），测量标准误差更好（SEM = 2.2°），选择终椎的误差指数有所改善（EI = 1.34），但评估者内部可靠性无统计学上的改善（p>0.05）。对于评估者2 - 4，US测量与X线片测量之间的ICC[2,1]值范围、SEM值以及EI值范围分别为0.70° - 0.72°、3.3°和1.65° - 2.36°。US检测曲线进展的特异性和敏感性分别为0.91和0.83。
使用先前的X线片作为测量辅助工具有助于使用者从US图像测量冠状面弯曲度，并提高了终椎选择的准确性。US在检测曲线进展方面显示出高敏感性和特异性，表明US可能是监测轻度或中度曲线的AIS患者的一种合适的、无辐射的替代方法。
