Ahmed Moustafa, Saad Ahmed, Bani-Khalid Aseel, Sonsale Paresh, Iyengar K P, Botchu Rajesh
Department of Orthopaedics, University Hospitals of Birmingham, Birmingham, UK.
Department of Orthopaedics, Royal Orthopedic Hospital, Birmingham, UK.
Emerg Radiol. 2023 Aug;30(4):419-423. doi: 10.1007/s10140-023-02146-5. Epub 2023 Jun 5.
Grey Scale Inversion Imaging (GSII), a radiology reading software, has been utilized to improve anatomical and pathological delineation and consequently increase the diagnostic accuracy in a variety of trauma and Orthopaedic conditions.
OBJECTIVE/AIM: The objective of this study was to assess whether Grey Scale Inversion Imaging (GSII) has any impact on the diagnostic accuracy and inter-observer reliability in diagnosing neck of femur fractures.
We performed a retrospective, single-centre study, to identify 50 consecutive anteroposterior (AP) pelvis radiographs of patients who presented to our unit with suspected neck of femur fractures between 2020 and 2021. The images included a combination of normal pelvic radiographs and others with features suggestive either intracapsular or extracapsular neck of femur fractures, which had been confirmed on computed tomography (CT), magnetic resonance imaging (MRI) and/or subsequent surgery. Four independent observers (two Trauma and Orthopaedics (T&O) consultants, one T&O Trainee Registrar (ST3 level) and one Trainee Senior House Officer (SHO in T&O) reviewed the images and graded each radiograph image using the Likert scale in response to the statement "there is a fracture". Following this, the same radiographs were inverted to Grey Scale Inversion Imaging (GSII) grey scale images and reassessed. RAND correlation was used for statistical analysis.
Overall, observers appeared to have similar accuracy with normal radiographic imaging and with GSI sequences.
Grey Scale Inversion Imaging (GSII) of digital radiographs did not affect the diagnostic accuracy of detecting neck of femur fractures in our study.
灰度反转成像（GSII）是一种放射学阅片软件，已被用于改善解剖结构和病理特征的显示，从而提高在各种创伤和骨科疾病中的诊断准确性。
本研究的目的是评估灰度反转成像（GSII）对股骨颈骨折诊断准确性和观察者间可靠性是否有影响。
我们进行了一项回顾性单中心研究，以识别2020年至2021年间因疑似股骨颈骨折前来我院就诊的患者的50张连续前后位（AP）骨盆X线片。这些图像包括正常骨盆X线片以及其他具有提示股骨颈囊内或囊外骨折特征的图像，这些骨折已通过计算机断层扫描（CT）、磁共振成像（MRI）和/或后续手术得到证实。四位独立观察者（两位创伤与骨科（T&O）顾问、一位T&O实习注册医师（ST3级别）和一位实习高级住院医师（T&O的SHO））对图像进行了评估，并根据“存在骨折”这一陈述使用李克特量表对每张X线片图像进行分级。之后，将相同的X线片转换为灰度反转成像（GSII）灰度图像并重新评估。采用RAND相关性进行统计分析。
总体而言，观察者在正常X线成像和GSI序列下的准确性似乎相似。
在我们的研究中，数字X线片的灰度反转成像（GSII）并未影响股骨颈骨折检测的诊断准确性。
