Nitschke Ashley, Lambert Jeffery R, Glueck Deborah H, Jesse Mary Kristen, Mei-Dan Omer, Strickland Colin, Petersen Brian
Division of Musculoskeletal Radiology, Department of Radiology, University of Colorado School of Medicine, University of Colorado Denver, Aurora, CO, USA.
Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Aurora, CO, USA.
Skeletal Radiol. 2015 Nov;44(11):1679-86. doi: 10.1007/s00256-015-2225-2. Epub 2015 Aug 4.
This study has three aims: (1) validate a new radiographic measure of acetabular version, the transverse axis distance (TAD) by showing equivalent TAD accuracy in predicting CT equatorial acetabular version when compared to a previously validated, but more cumbersome, radiographic measure, the p/a ratio; (2) establish predictive equations of CT acetabular version from TAD; (3) calculate a sensitive and specific cut point for predicting excessive CT acetabular anteversion using TAD.
A 14-month retrospective review was performed of patients who had undergone a dedicated MSK CT pelvis study and who also had a technically adequate AP pelvis radiograph. Two trained observers measured the radiographic p/a ratio, TAD, and CT acetabular equatorial version for 110 hips on a PACS workstation. Mixed model analysis was used to find prediction equations, and ROC analysis was used to evaluate the diagnostic accuracy of p/a ratio and TAD.
CT equatorial acetabular version can accurately be predicted from either p/a ratio (p < 0.001) or TAD (p < 0.001). The diagnostic accuracies of p/a ratio and TAD are comparable (p =0.46). Patients whose TAD is higher than 17 mm may have excessive acetabular anteversion. For that cutpoint, the sensitivity of TAD is 0.73, with specificity of 0.82.
TAD is an accurate radiographic predictor of CT acetabular anteversion and provides an easy-to-use and intuitive point-of-care assessment of acetabular version in patients with hip pain.
本研究有三个目标：（1）通过显示在预测CT赤道髋臼旋转角度方面，横轴距离（TAD）与先前验证过但更繁琐的放射学测量方法（p/a比值）具有同等的TAD准确性，来验证一种新的髋臼旋转角度的放射学测量方法；（2）建立从TAD预测CT髋臼旋转角度的预测方程；（3）计算使用TAD预测CT髋臼过度前倾的敏感且特异的切点。
对14个月内接受过专用MSK CT骨盆检查且同时有技术上合格的骨盆前后位X线片的患者进行回顾性研究。两名经过培训的观察者在PACS工作站上测量了110个髋关节的放射学p/a比值、TAD和CT髋臼赤道旋转角度。采用混合模型分析来寻找预测方程，并采用ROC分析来评估p/a比值和TAD的诊断准确性。
CT赤道髋臼旋转角度可以从p/a比值（p < 0.001）或TAD（p < 0.001）准确预测。p/a比值和TAD的诊断准确性相当（p = 0.46）。TAD高于17 mm的患者可能存在髋臼过度前倾。对于该切点，TAD的敏感性为0.73，特异性为0.82。
TAD是CT髋臼前倾的准确放射学预测指标，为髋部疼痛患者的髋臼旋转角度提供了一种易于使用且直观的床旁评估方法。
