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应用超声影像学方法评估特发性脊柱侧凸患儿的脊柱弯曲进展情况。

Assessment of curve progression on children with idiopathic scoliosis using ultrasound imaging method.

机构信息

Department of Surgery, University of Alberta, Edmonton, Canada.

Alberta Health Services, Edmonton, Canada.

出版信息

Eur Spine J. 2018 Sep;27(9):2114-2119. doi: 10.1007/s00586-017-5457-0. Epub 2018 Jan 10.

Abstract

PURPOSE

To investigate the threshold of the curve difference on ultrasound measurement relative to the previous radiographic measurements to detect curves progression in children who have idiopathic scoliosis (IS).

METHODS

Two hundred children with IS (F:170, M:30; mean age: 14.6 ± 1.9) were recruited from a single center. A retrospective study on comparing the current ultrasound measurements with the previous radiographic measurements with threshold values from 3° to 8° to detect curve progression was conducted. The receiver operating characteristic (ROC) analysis, accuracy (ACC), and odd ratio (OR) were calculated to determine the optimal threshold value of the curve differences between ultrasound and previous radiographic measurement.

RESULTS

Both thresholds of 4° and 5° for curve difference from ultrasound scans presented the sensitivities ≥ 0.90 and specificities ≥ 0.85, and can reduce by 73 and 79% of radiographs on the studied subjects, respectively. Especially, for 4° threshold, the negative likelihood ratio (LR-) was only 0.08, which indicated that there is only 8% probability that the subject has progressed if the US measurement detected non-progression.

CONCLUSIONS

The ultrasound imaging method can be applied to identify curve progression in children with IS. Four degree is the preferred threshold value to detect the curve which had progressed, since it also had the lower rate of undetected progressed cases (false negatives).

摘要

目的

探讨超声测量相对于既往影像学测量的曲线差值阈值,以检测特发性脊柱侧凸(IS)患儿的曲线进展。

方法

从单一中心招募了 200 名特发性脊柱侧凸患儿(女性 170 名,男性 30 名;平均年龄 14.6±1.9 岁)。对当前超声测量与既往影像学测量进行了回顾性研究,阈值范围为 3°至 8°,以检测曲线进展。计算了受试者工作特征(ROC)分析、准确性(ACC)和比值比(OR),以确定超声和既往影像学测量的曲线差值的最佳阈值。

结果

超声扫描曲线差值的 4°和 5°阈值的灵敏度均≥0.90,特异性均≥0.85,可分别减少研究对象 73%和 79%的影像学检查。特别是,4°阈值的负似然比(LR-)仅为 0.08,这表明如果超声测量未检测到进展,患者进展的可能性只有 8%。

结论

超声成像方法可用于识别特发性脊柱侧凸患儿的曲线进展。4 度是检测已进展曲线的首选阈值,因为它也具有较低的未检出进展病例(假阴性)率。

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