Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China.
College of Computer Science and Technology, Zhejiang University of Technology, Hangzhou, China.
Ultrasound Med Biol. 2019 Oct;45(10):2725-2735. doi: 10.1016/j.ultrasmedbio.2019.05.031. Epub 2019 Jul 12.
The objective of this study was to test the reliability of sagittal spinal curvature measurements using 3-D ultrasound in patients with adolescent idiopathic scoliosis (AIS). Ultrasound spinous process angle (USSPA) and ultrasound laminae angle (USLA) were measured on sagittal ultrasound images, while the Cobb angle (XCA) was measured on sagittal X-ray images. Intra-class correlation coefficients (ICC) for the intra- and inter-observer variability, linear regression analysis and Bland-Altman method, including mean absolute difference (MAD), were investigated to evaluate the reliability and validity of the two ultrasound angles compared with XCA. Excellent measurement reliabilities were demonstrated for both ultrasound angles (ICC ≥ 0.91). Moderate to good and significant linear correlations and good agreement were demonstrated between the ultrasound methods and XCA (Thoracic [R ≥ 0.574] / Lumbar [R ≥ 0.635]). No significant differences were found for the MADs between both corrected ultrasound angles and XCA. Sagittal ultrasound angles were demonstrated to be reliable for assessing sagittal curvature using spinous processes and laminae and to have good and significant correlations with XCAs. Since it is non-ionizing and relatively low cost, this method opens the possibility of providing frequent curve monitoring and evaluation, and screening for AIS patients, particularly based on sagittal profiles.
本研究旨在测试使用三维超声测量青少年特发性脊柱侧凸（AIS）患者矢状位脊柱曲度的可靠性。在矢状位超声图像上测量棘突角（USSPA）和超声椎板角（USLA），在矢状位 X 射线图像上测量 Cobb 角（XCA）。研究了内-观察者和间-观察者变异性的组内相关系数（ICC）、线性回归分析和 Bland-Altman 法，包括平均绝对差（MAD），以评估两种超声角度与 XCA 的可靠性和有效性。两种超声角度的测量可靠性均为优秀（ICC≥0.91）。超声方法与 XCA 之间具有中度至良好且显著的线性相关性和良好的一致性（胸椎[R≥0.574]/腰椎[R≥0.635]）。校正后的两种超声角度与 XCA 之间的 MAD 没有显著差异。结果表明，使用棘突和椎板的矢状位超声角度可用于评估矢状位曲度，并且与 XCA 具有良好且显著的相关性。由于它是非电离的且相对成本较低，因此该方法有可能提供频繁的曲线监测和评估，以及对 AIS 患者进行筛查，特别是基于矢状位轮廓。
