与常规的侧位胸椎 X 射线相比，胸部 CT 和 DXA 对脊柱侧凸的诊断。
Diagnosis of vertebral deformities on chest CT and DXA compared to routine lateral thoracic spine X-ray.
机构信息
Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands.
Department of Respiratory Medicine, Catharina Hospital, Eindhoven, the Netherlands.
出版信息
Osteoporos Int. 2018 Jun;29(6):1285-1293. doi: 10.1007/s00198-018-4412-1. Epub 2018 Feb 12.
UNLABELLED
X-ray, CT and DXA enable diagnosis of vertebral deformities. For this study, level of agreement of vertebral deformity diagnosis was analysed. We showed that especially on subject level, these imaging techniques could be used for opportunistic screening of vertebral deformities in COPD patients.
INTRODUCTION
X-ray and CT are frequently used for pulmonary evaluation in patients with chronic obstructive pulmonary disease (COPD) and also enable to diagnose vertebral deformities together with dual-energy X-ray absorptiometry (DXA) imaging. The aim of this research was to study the level of agreement of these imaging modalities for diagnosis of vertebral deformities from T4 to L1.
METHODS
Eighty-seven subjects (mean age of 65; 50 males; 57 COPD patients) who had X-ray, chest CT (CCT) and DXA were included. Evaluable vertebrae were scored twice using SpineAnalyzer™ software. ICCs and kappas were calculated to examine intra-observer variability. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the receiver operating characteristic curve (AUROC) were calculated to compare vertebral deformities diagnosed on the different imaging modalities.
RESULTS
ICCs for height measurements were excellent (> 0.94). Kappas were good to excellent (0.64-0.77). At vertebral level, the AUROC was 0.85 for CCT vs. X-ray, 0.74 for DXA vs. X-ray and 0.77 for DXA vs. CCT. Sensitivity (51%-73%) and PPV (57%-70%) were fair to good; specificity and NPV were excellent (≥ 96%). At subject level, the AUROC values were comparable.
CONCLUSIONS
Reproducibility of height measurements of vertebrae is excellent with all three imaging modalities. On subject level, diagnostic performance of CT (PPV 79-82%; NPV 90-93%), and to a slightly lesser extend of DXA (PPV 73-77%; NPV 80-89%), indicates that these imaging techniques could be used for opportunistic screening of vertebral deformities in COPD patients.
目的
X 射线、CT 和 DXA 可用于诊断脊柱畸形。本研究分析了脊柱畸形诊断的一致性。我们表明，特别是在个体水平上，这些成像技术可用于 COPD 患者的脊柱畸形机会性筛查。
简介
X 射线和 CT 常用于慢性阻塞性肺疾病（COPD）患者的肺部评估，也可与双能 X 射线吸收法（DXA）成像一起诊断脊柱畸形。本研究旨在研究 T4 至 L1 脊柱畸形的这些成像方式的诊断一致性。
方法
纳入了 87 名接受 X 射线、胸部 CT（CCT）和 DXA 检查的患者（平均年龄 65 岁；男性 50 名；57 名 COPD 患者）。使用 SpineAnalyzer™软件两次对可评估的椎体进行评分。计算 ICC 和 Kappa 以评估观察者内的变异性。计算灵敏度、特异性、阳性预测值（PPV）、阴性预测值（NPV）和受试者工作特征曲线下的面积（AUROC），以比较不同成像方式诊断的脊柱畸形。
结果
椎体高度测量的 ICC 很高（>0.94）。Kappa 值为良好至优秀（0.64-0.77）。在椎体水平，CCT 与 X 射线的 AUROC 为 0.85，DXA 与 X 射线的 AUROC 为 0.74，DXA 与 CCT 的 AUROC 为 0.77。灵敏度（51%-73%）和 PPV（57%-70%）为中等至良好；特异性和 NPV 均很高（≥96%）。在个体水平，AUROC 值相当。
结论
三种成像方式的椎体高度测量重复性均极佳。在个体水平，CT（PPV 79-82%；NPV 90-93%）和稍差一些的 DXA（PPV 73-77%；NPV 80-89%）的诊断性能表明，这些成像技术可用于 COPD 患者的脊柱畸形机会性筛查。
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