Resident of Radiology, e Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Department of Radiology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
BMC Musculoskelet Disord. 2020 Jun 26;21(1):405. doi: 10.1186/s12891-020-03441-9.
In the current diagnostic procedure, generally, both plain radiographs and 3D-CT scans are used for the diagnosis of acetabular fractures. There is no consensus regarding the value of a three-dimensional computerized tomographic (3D-CT) scan alone in the classification of acetabular fractures. In this study, we compared the accuracy of 3D-CT scan and plain radiography through the evaluation of their agreement with the intraoperative surgeon's classification.
In a retrospective study, patients who were referred to our center with an acetabular fracture and underwent surgical treatment were included. The classification of acetabular fractures was performed once using Judet view plain radiographs and once using a 3D-CT scan by the corresponding one Experienced musculoskeletal radiologist one independent trauma fellowship-trained orthopaedic who routinely treat acetabular fractures and based on Letournel and Judet classification (17 and 23 years of experience respectively). Cohen's kappa value was used for the assessment agreement between the two imaging modalities, as well as between the imaging modalities and intraoperative classification.
Medical files of 152 patients with acetabular fracture were retrospectively reviewed. A kappa value of 0.236 was obtained as the agreement level between radiographs and intraoperative findings (p < 0.001). A kappa value of 0.943 was obtained as the agreement level between 3D-CT and intraoperative classification (p < 0.001). An agreement level of 0.264 was found between the Judet radiographs and 3D-CT scans (p < 0.001).
3D-CT scans are reliable enough in the classification of acetabular fractures, and plain radiographs could be omitted to avoid radiation exposure as well as to reduce the cost for patients who sustain acetabular fractures.
在当前的诊断程序中，通常同时使用普通 X 光片和 3D-CT 扫描来诊断髋臼骨折。对于单独使用三维计算机断层扫描（3D-CT）扫描对髋臼骨折进行分类的价值，尚无共识。在这项研究中，我们通过评估其与术中外科医生分类的一致性，比较了 3D-CT 扫描和普通 X 光片的准确性。
在一项回顾性研究中，我们纳入了因髋臼骨折并接受手术治疗而被转诊至我们中心的患者。髋臼骨折的分类由一位有经验的肌肉骨骼放射科医生和一位常规治疗髋臼骨折的创伤 fellowship培训骨科医生分别使用 Judet 视图普通 X 光片和 3D-CT 扫描进行一次。基于 Letournel 和 Judet 分类（分别有 17 年和 23 年的经验）。我们使用 Cohen 的kappa 值评估两种成像方式之间以及成像方式与术中分类之间的一致性。
回顾性审查了 152 例髋臼骨折患者的病历。X 光片和术中发现之间的一致性kappa 值为 0.236（p<0.001）。3D-CT 与术中分类之间的一致性 kappa 值为 0.943（p<0.001）。Judet X 光片和 3D-CT 扫描之间的一致性水平为 0.264（p<0.001）。
3D-CT 扫描在髋臼骨折的分类中足够可靠，可以省略普通 X 光片，以避免辐射暴露，并降低髋臼骨折患者的成本。
