Debnam James M, Chi Tzehping L, Ketonen Leena, Wei Wei, Guha-Thakurta Nandita
From the Section of Neuroradiology, Department of Diagnostic Imaging, and.
Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX.
J Comput Assist Tomogr. 2019 Jan/Feb;43(1):76-84. doi: 10.1097/RCT.0000000000000784.
The objective of this study was to compare multidetector computed tomography (MDCT) images with volume-rendered translucent display (VRTLD) series to plain radiographs for evaluating spinal surgical instrumentation after resection and reconstruction for spinal malignancies.
In 44 patients with tumor resection and spinal reconstruction, 17 with complications, 3 neuroradiologists evaluated plain radiographs, MDCT images alone, VRTLD images alone, and MDCT images with VRTLD images for identifying complications in 3 categories: subsidence/migration, construct fracture, and screw loosening. Each category was scored as 1 (complications), 2 (no complications), or 3 (not sure), and the minimum score was used for analyses. Clinical/surgical outcomes were the reference standard.
Sensitivity, specificity, and accuracy (95% confidence interval), respectively, were as follows: MDCT/VRTLD, 100%, 100%, 100% (91.96%-100.00%); MDCT alone, 88.24%, 100%, 95.45% (84.53%-99.44%); VRTLD alone, 82.35%, 96.3%, 90.91% (78.33%-97.47%); plain radiographs, 52.94%, 100%, 81.82% (67.29%-91.81%).
Multidetector computed tomography with VRTLD series seems best for evaluation of spinal instrumentation after tumor resection and reconstruction.
本研究的目的是比较多排螺旋计算机断层扫描（MDCT）图像与容积再现透明显示（VRTLD）系列图像和普通X线片，以评估脊柱恶性肿瘤切除重建术后的脊柱手术内固定情况。
在44例接受肿瘤切除及脊柱重建的患者中，17例有并发症，3名神经放射科医生评估普通X线片、单独的MDCT图像、单独的VRTLD图像以及MDCT图像与VRTLD图像，以识别3类并发症：下沉/移位、内固定骨折和螺钉松动。每类评分为1分（有并发症）、2分（无并发症）或3分（不确定），并采用最低评分进行分析。临床/手术结果为参考标准。
敏感性、特异性和准确性（95%置信区间）分别如下：MDCT/VRTLD，100%、100%、100%（91.96%-100.00%）；单独MDCT，88.24%、100%、95.45%（84.53%-99.44%）；单独VRTLD，82.35%、96.3%、90.91%（78.33%-97.47%）；普通X线片，52.94%、100%、81.82%（67.29%-91.81%）。
多排螺旋计算机断层扫描与VRTLD系列图像似乎最适合评估肿瘤切除重建术后的脊柱内固定情况。
