Department of Radiology, Leiden University Medical Center, Leiden, Netherlands.
Department of Rheumatology, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands.
Ann Rheum Dis. 2018 Mar;77(3):371-377. doi: 10.1136/annrheumdis-2017-212553. Epub 2017 Nov 10.
To develop the CT Syndesmophyte Score (CTSS) for low-dose CT (ldCT) to assess structural damage in the spine of patients with ankylosing spondylitis (AS) and test its reliability.
Patientswith AS in the SIAS cohort had whole spine ldCT at baseline and 2 years. Syndesmophytes were scored in coronal and sagittal planes in eight quadrants per vertebral unit (VU) as absent=0, <50% of the intervertebral disc space (IDS)=1, ≥50%=2 or bridging the IDS=3 (range 0-552). Images were scored by two readers, paired by patient, blinded to time order. Whole spine and spinal segment status and change scores were calculated. Inter-reader reliability was assessed by intraclass correlation coefficient (ICC), smallest detectable change (SDC) and frequency of scores per VU.
49 patients (mean age 50 years (SD 9.8), 84% men, 88% human leucocyte antigen B27 positive) were included. Mean (SD) scores of reader 1 were: whole spine baseline status score 163 (126) and change score 16 (21), spinal segment baseline status scores 30 (41), 97 (77) and 36 (36) and change scores 2 (7), 12 (18) and 3 (4) for the cervical, thoracic and lumbar spine, respectively. Scores of reader 2 were similar. Whole spine status score ICC was 0.99 and 0.97-0.98 for spinal segments. Whole spine change score ICC was 0.77 and 0.32-0.75 for spinal segments. Whole-spine SDC was 14.4. Score distribution pattern per VU was similar between readers.
Using the CTSS, new bone formation in the spine of patients with AS can be assessed reliably. Most progression was seen in the thoracic spine.
开发用于低剂量 CT（ldCT）的 CT 骨桥评分（CTSS），以评估强直性脊柱炎（AS）患者脊柱的结构损伤，并对其可靠性进行测试。
SIAS 队列中的 AS 患者在基线和 2 年时进行全脊柱 ldCT。在每个椎骨单位（VU）的 8 个象限中，在冠状面和矢状面评估骨桥，评分标准为：无=0、<50%椎间盘空间（IDS）=1、≥50%=2 或跨越 IDS=3（范围 0-552）。由两位读者对图像进行评分，读者两两配对，按患者编号，彼此不了解评分时间顺序。计算全脊柱和脊柱节段状态和变化评分。通过组内相关系数（ICC）、最小可检测变化（SDC）和每 VU 评分的频率评估读者间的可靠性。
共纳入 49 名患者（平均年龄 50 岁（9.8 岁），84%为男性，88%人类白细胞抗原 B27 阳性）。读者 1 的平均（标准差）评分如下：全脊柱基线状态评分 163（126）和变化评分 16（21），脊柱节段基线状态评分 30（41）、97（77）和 36（36），以及变化评分 2（7）、12（18）和 3（4），分别用于颈椎、胸椎和腰椎。读者 2 的评分相似。全脊柱状态评分 ICC 为 0.99，脊柱节段 ICC 为 0.97-0.98。全脊柱变化评分 ICC 为 0.77，脊柱节段 ICC 为 0.32-0.75。全脊柱 SDC 为 14.4。两位读者的 VU 评分分布模式相似。
使用 CTSS 可可靠地评估 AS 患者脊柱的新骨形成。大多数进展发生在胸椎。
