用于评估肱骨头颅尾位的5种测量方法的可靠性和鉴别准确性：基于传统X线片的评估
Reliability and discriminative accuracy of 5 measures for craniocaudal humeral position: an assessment on conventional radiographs.
作者信息
Kolk Arjen, Overbeek Celeste L, de Groot Jurriaan H, Nelissen Rob G H H, Nagels Jochem
机构信息
Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands.
Laboratory for Kinematics and Neuromechanics, Department of Orthopaedics and Rehabilitation, Leiden University Medical Center, Leiden, The Netherlands.
出版信息
JSES Int. 2020 Feb 29;4(1):189-196. doi: 10.1016/j.jseint.2019.11.005. eCollection 2020 Mar.
HYPOTHESIS
This study aimed to examine the reliability and diagnostic discriminative accuracy of 5 different methods that quantity the craniocaudal humeral position with respect to the scapula on conventional radiographs.
METHODS
In this retrospective, cross-sectional diagnostic study, 2 observers randomly assessed the conventional anteroposterior shoulder radiographs of 280 subjects with rotator cuff imaging for the (1) acromiohumeral (AH) interval, (2) upward migration index (UMI), (3) glenohumeral center-to-center measurement (GHCC), (4) glenohumeral arc measurement (GHa), and (5) scapular spine-humeral head center method (SHC). Reliability was assessed by means of relative consistency (intraclass correlation coefficient) and absolute consistency. Discriminative accuracy for detecting a rotator cuff tear was calculated.
RESULTS
Relative consistency (intraclass correlation coefficient) for the AH interval, UMI, GHCC, GHa, and SHC was 0.961, 0.913, 0.806, 0.924, and 0.726, respectively. The AH interval had the highest absolute consistency with a random residual measurement error of 0.58 mm compared with 1.0-3.2 mm for the other measurements. The discriminative accuracy of the AH interval did not significantly differ from that of the UMI (-0.010; 95% confidence interval [CI], -0.042 to 0.022; = .545) but was significantly better than that of the GHCC (0.112; 95% CI, 0.043-0.181; = .001), GHa (0.074; 95% CI, 0.009-0.139; = .027), and SHC (0.178; 95% CI, 0.100-0.256; < .001).
CONCLUSION
Assessment of the craniocaudal humeral position is performed with good to excellent intraobserver and interobserver reliability. The discriminative accuracy for detecting a rotator cuff tear on a single radiograph was highest for the AH interval and UMI. We recommend using the AH interval or UMI as an indirect measure of the presence of a rotator cuff tear on conventional radiographs.
假设
本研究旨在检验5种不同方法在传统X线片上测量肱骨相对于肩胛骨的颅尾位的可靠性和诊断鉴别准确性。
方法
在这项回顾性横断面诊断研究中，2名观察者随机评估了280例进行肩袖成像的受试者的传统肩部前后位X线片，测量指标包括：(1)肩峰肱骨(AH)间隙、(2)上移指数(UMI)、(3)盂肱中心到中心测量(GHCC)、(4)盂肱弧测量(GHa)和(5)肩胛冈-肱骨头中心法(SHC)。通过相对一致性（组内相关系数）和绝对一致性评估可靠性。计算检测肩袖撕裂的鉴别准确性。
结果
AH间隙、UMI、GHCC、GHa和SHC的相对一致性（组内相关系数）分别为0.961、0.913、0.806、0.924和0.726。AH间隙的绝对一致性最高，随机残余测量误差为0.58 mm，而其他测量的误差为1.0 - 3.2 mm。AH间隙的鉴别准确性与UMI相比无显著差异（-0.010；95%置信区间[CI]，-0.042至0.022；P = 0.545），但显著优于GHCC（0.112；95% CI，0.043 - 0.181；P = 0.001）、GHa（0.074；95% CI，0.009 - 0.139；P = 0.027）和SHC（0.
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