Phexell Erika, Åkesson Anna, Söderberg Marcus, Bolejko Anetta
Department of Medical Imaging and Physiology, Skåne University Hospital, Malmö, Sweden.
Department of Health Sciences, Lund University, Lund, Sweden.
Acta Radiol Open. 2019 Jun 11;8(6):2058460119855187. doi: 10.1177/2058460119855187. eCollection 2019 Jun.
Different low-dose computed tomography (CT) pelvimetry methods can be used to evaluate the size of birth canal before delivery. CT pelvimetry might generate an acceptable low fetal radiation dose but its measurement accuracy is unknown.
To investigate intra- and inter-rater measurement reliability of cross-sectional and two spiral CT pelvimetry methods: standard spiral and short spiral.
Ten individuals (age ≥60 years, body mass index ≥30 kg/m) having a CT scan of the abdomen also had CT pelvimetry scans. Three radiologists made independent measurements of each pelvimetry method on two occasions and also in consensus for a reference pelvimetry computed from the standard-dose CT scan of the abdomen. Inter- and intra-rater reliability was analyzed by intraclass correlation coefficient.
Measurements in the short spiral pelvimetry demonstrated excellent intra- and inter-rater reliability, intraclass correlation coefficient ≥0.93, and good to excellent 95% confidence interval 0.87-0.99. Corresponding results of the standard spiral and cross-sectional pelvimetry showed good to excellent intraclass correlation coefficient ≥0.85 and ≥0.76, and 95% confidence interval was least good and moderate 0.73-0.98 and 0.59-0.97, respectively. Intraclass correlation coefficient between reference pelvimetry and other CT methods showed analogous results.
The short spiral pelvimetry demonstrated high and best reliability in comparison to other methods. Standard spiral method showed also good measurement reliability but the short spiral pelvimetry generates lower fetal radiation dose. This method might be suitable for measurements at narrow pelvis. Patient acceptance and attitude to CT pelvimetry should be investigated.
不同的低剂量计算机断层扫描（CT）骨盆测量方法可用于分娩前评估产道大小。CT骨盆测量可能会产生可接受的低胎儿辐射剂量，但其测量准确性尚不清楚。
研究横断面和两种螺旋CT骨盆测量方法（标准螺旋和短螺旋）的观察者内和观察者间测量可靠性。
10名年龄≥60岁、体重指数≥30kg/m的个体进行了腹部CT扫描，同时也进行了CT骨盆测量扫描。三名放射科医生在两个不同时间对每种骨盆测量方法进行独立测量，并就根据腹部标准剂量CT扫描计算出的参考骨盆测量达成共识。通过组内相关系数分析观察者间和观察者内的可靠性。
短螺旋骨盆测量的测量结果显示出优异的观察者内和观察者间可靠性，组内相关系数≥0.93，95%置信区间为0.87-0.99，良好至优异。标准螺旋和横断面骨盆测量的相应结果显示组内相关系数良好至优异，分别≥0.85和≥0.76，95%置信区间分别为最差良好和中等，分别为0.73-0.98和0.59-0.97。参考骨盆测量与其他CT方法之间的组内相关系数显示出类似结果。
与其他方法相比，短螺旋骨盆测量显示出高且最佳的可靠性。标准螺旋方法也显示出良好的测量可靠性，但短螺旋骨盆测量产生的胎儿辐射剂量更低。该方法可能适用于狭窄骨盆的测量。应研究患者对CT骨盆测量的接受度和态度。
