Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland.
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland.
Osteoarthritis Cartilage. 2016 Jul;24(7):1167-71. doi: 10.1016/j.joca.2016.01.982. Epub 2016 Jan 30.
To determine the diagnostic performance of tomosynthesis in depicting osteoarthritic lesions in comparison to conventional radiographs, with use of computed tomography (CT) as standard-of-reference.
Imaging of 12 cadaveric hands was performed with tomosynthesis in dorso-palmar (dp) projection, conventional radiographs (dp) and multi-detector CT. Distal interphalangeal joint (DIP)II, DIPIII, proximal interphalangeal joint (PIP)II, PIPIII, first carpometacarpal (CMC) and scaphotrapezotrapezoidal joint (STT) were graded by two independent readers using the Osteoarthritis Research Society International (OARSI) score. The mean score for each feature was calculated for all modalities. Additional wrists were evaluated for presence of calcium pyrophosphate disease (CPPD). CT served as reference-standard. Inter-reader agreement (ICC) was calculated.
Comparing tomosynthesis and conventional radiographs to CT, the sensitivity for the presence of osteophytes was 95,7% vs 65,2%; for joint space narrowing 95,8% vs 52,1%; for subchondral sclerosis 61,5% vs 51,3%; for lateral deformity 83.3% vs 83,3%; and for subchondral cysts 45,8% vs 29,2%. Erosions were not present. While tomosynthesis showed no significant difference in OARSI score grading to CT (mean OARSI-score CT: 16.8, SD = 10.6; mean OARSI-score Tomosynthesis: 16.3, SD = 9.6; P = 0.84), conventional radiographs had significant lower mean OARSI scores (mean OARSI-score X-ray: 11.1, SD = 8.3; P = 0.04). Inter-reader agreement for OARSI scoring was excellent (ICC = 0.99). CPPD calcifications present in CT, were also visible with tomosynthesis, but not with conventional radiography.
In conclusion, tomosynthesis depicts more osteoarthritic changes in the small joints of the hand than conventional radiography using the OARSI scoring system and CT as the standard of reference.
通过与作为参考标准的计算机断层扫描（CT）比较，确定断层合成在描述骨关节炎病变方面的诊断性能。
对 12 具尸体手进行断层合成（背掌位，dp）、常规射线照相（dp）和多探测器 CT 成像。使用骨关节炎研究协会国际（OARSI）评分，由两位独立的读者对远节指间关节（DIP）II、DIPIII、近节指间关节（PIP）II、PIPIII、第一掌腕关节（CMC）和舟状骨-大多角骨关节（STT）进行分级。计算所有模态的每个特征的平均得分。对额外的手腕进行焦磷酸钙疾病（CPPD）的评估。CT 作为参考标准。计算了读者间的一致性（ICC）。
与 CT 相比，断层合成和常规射线照相在存在骨赘方面的敏感性分别为 95.7%和 65.2%；关节间隙狭窄为 95.8%和 52.1%；软骨下硬化为 61.5%和 51.3%；侧向畸形为 83.3%和 83.3%；软骨下囊肿为 45.8%和 29.2%。无侵蚀。尽管断层合成在 OARSI 评分分级方面与 CT 无显著差异（CT 平均 OARSI 评分：16.8，SD=10.6；断层合成平均 OARSI 评分：16.3，SD=9.6；P=0.84），但常规射线照相的平均 OARSI 评分显著较低（X 射线平均 OARSI 评分：11.1，SD=8.3；P=0.04）。OARSI 评分的读者间一致性极好（ICC=0.99）。CT 中存在的 CPPD 钙化也可以通过断层合成看到，但不能通过常规放射摄影看到。
总之，与使用 OARSI 评分系统和 CT 作为参考标准的常规射线照相相比，断层合成在描述手部小关节的骨关节炎变化方面表现出更多的变化。
