Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, 120-1 Neungdong-Ro (Hwayang-Dong), Gwangjin-Gu, Seoul, 143-729, Republic of Korea.
Division of Rheumatology, Department of Internal Medicine, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea.
Sci Rep. 2023 Jan 23;13(1):1283. doi: 10.1038/s41598-023-28525-z.
The CT syndesmophyte score (CTSS) can evaluate spinal progression more precisely than mSASSS in ankylosing spondylitis (AS); however, it is complex and time consuming. Here, we propose a simplified CTSS (sCTSS) for measuring spinal structural changes in AS. Patients with AS were recruited from a single tertiary hospital. Baseline and 2-year follow-up whole spine CT images were used to calculate CTSS and sCTSS. The sCTSS used the anterior and posterior vertebral corners, and ranged 0-184. Intraclass correlation coefficients (ICC) were calculated, as well as the smallest detectable changes. Fifty AS patients were included. For reader 1, the mean sCTSS at baseline and 2-year follow-up were 11.7 ± 14.6 and 15.8 ± 16.1, whereas those for reader 2 were 12.0 ± 12.5 and 15.8 ± 15.7, respectively. The ICCs for CTSS at baseline and at 2-year follow-up were 0.97 (95% confidence interval [CI] 0.96-0.99) and 0.98 (0.97-0.99), respectively, and that for changes over the 2 years was 0.48 (95% CI 0.23-0.67). For sCTSS, the ICCs were 0.96 (95% CI 0.92-0.97), 0.97 (95% CI 0.94-0.98), and 0.58 (95% CI 0.36-0.74), respectively. Detection rates for syndesmophyte progression were comparable between CTSS and sCTSS. The detection rate for syndesmophytes on only lateral side was 13.2 and 11.4%, and 11.4 and 15.2% at baseline and 2-year follow-up (reader 1 and 2). sCTSS and CTSS showed similar detection rates for syndesmophyte progression. sCTSS may be a reliable method for evaluating spinal structural damage in AS.
CT 骨桥评分（CTSS）可较 mSASSS 更精确地评估强直性脊柱炎（AS）的脊柱进展；但该评分较为复杂且耗时。本研究提出一种简化的 CTSS（sCTSS）来评估 AS 的脊柱结构变化。从一家三级医院招募 AS 患者。使用基线和 2 年随访的全脊柱 CT 图像来计算 CTSS 和 sCTSS。sCTSS 使用前、后椎体角，范围 0-184。计算了组内相关系数（ICC）和最小可检测变化。纳入 50 例 AS 患者。对于读者 1，基线和 2 年随访时 sCTSS 的均值分别为 11.7±14.6 和 15.8±16.1，而读者 2 的相应值分别为 12.0±12.5 和 15.8±15.7。CTSS 基线和 2 年随访时的 ICC 分别为 0.97（95%置信区间[CI] 0.96-0.99）和 0.98（0.97-0.99），2 年时的变化 ICC 为 0.48（95%CI 0.23-0.67）。sCTSS 的 ICC 分别为 0.96（95%CI 0.92-0.97）、0.97（95%CI 0.94-0.98）和 0.58（95%CI 0.36-0.74）。CTSS 和 sCTSS 对骨桥进展的检出率相似。基线和 2 年随访时仅在侧位上发现骨桥的检出率分别为 13.2%和 11.4%（读者 1 和 2）和 11.4%和 15.2%（读者 1 和 2）。sCTSS 和 CTSS 对骨桥进展的检出率相似。sCTSS 可能是一种可靠的评估 AS 脊柱结构损伤的方法。
