Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
RMD Open. 2023 Mar;9(1). doi: 10.1136/rmdopen-2022-002959.
To assess construct validity of the CT Syndesmophyte Score (CTSS) for the measurement of structural spinal damage in patients with radiographic axial spondyloarthritis.
Low-dose CT and conventional radiography (CR) were performed at baseline and 2 years. CT was assessed with CTSS by two readers and CR with modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) by three readers. Two hypotheses were tested: (1) syndesmophytes scored with CTSS are also detected with mSASSS at baseline or 2 years later; (2) CTSS is non-inferior to mSASSS in correlations with spinal mobility measures. Presence of a syndesmophyte was determined per reader per corner for all anterior cervical and lumbar corners on CT at baseline and CR at baseline and 2 years. Correlations of CTSS and mSASSS with six spinal/hip mobility measurements plus Bath Ankylosing Spondylitis Metrology Index (BASMI) were tested.
Data from 48 patients (85% male, 85% HLA-B27+, mean age 48 years) were available for hypothesis 1 and 41/48 were available for hypothesis 2. At baseline, syndesmophytes were scored with CTSS in 348 (reader 1, 38%) and 327 (reader 2, 36%) corners out of 917. Of these, depending on reader pairs, 62%-79% were also seen on CR at baseline or after 2 years. CTSS correlated well ( 0.46-0.73), and with higher correlation coefficients than mSASSS ( 0.34-0.64), with all spinal mobility measures and BASMI.
The good agreement between syndesmophytes detected by CTSS and mSASSS and the strong correlation of CTSS with spinal mobility support the construct validity of the CTSS.
评估 CT 骨桥评分（CTSS）在测量放射学轴向脊柱关节炎患者结构脊柱损伤方面的结构效度。
在基线和 2 年内进行低剂量 CT 和常规放射摄影（CR）。由两位读者使用 CTSS 评估 CT，由三位读者使用改良 Stoke 强直性脊柱炎脊柱评分（mSASSS）评估 CR。测试了两个假设：（1）使用 CTSS 评分的骨桥也可以在基线或 2 年后用 mSASSS 检测到；（2）CTSS 在与脊柱活动度测量的相关性方面不劣于 mSASSS。在基线时，对所有前颈椎和腰椎 CT 角以及 CR 角的每个前角和后角，根据每个读者的情况确定骨桥的存在。测试了 CTSS 和 mSASSS 与六个脊柱/髋关节活动度测量值以及 Bath 强直性脊柱炎计量指数（BASMI）之间的相关性。
有 48 名患者（85%为男性，85%为 HLA-B27+，平均年龄 48 岁）的数据可用于假设 1，有 41/48 名患者的数据可用于假设 2。在基线时，348 个（读者 1，38%）和 327 个（读者 2，36%）角的 CTSS 可以对骨桥进行评分，这些角的数量为 917 个。根据读者对，这些角中 62%-79%也可以在基线或 2 年后的 CR 上看到。CTSS 与所有脊柱活动度测量值和 BASMI 的相关性良好（0.46-0.73），并且与 mSASSS（0.34-0.64）的相关性更高。
CTSS 检测到的骨桥与 mSASSS 之间的良好一致性以及 CTSS 与脊柱活动度的强相关性支持 CTSS 的结构有效性。
