Wantz William, Le Roy Julien, Lukas Cédric, Cyteval Catherine, Pastor Maxime
Osteoarticular Medical Imaging section, Department of Medical Imaging, hôpital Lapeyronie, CHU de Montpellier, Montpellier, France.
Radiophysics and radiation protection section, hôpital Lapeyronie, CHU de Montpellier, Montpellier, France.
Res Diagn Interv Imaging. 2023 Sep 19;8:100034. doi: 10.1016/j.redii.2023.100034. eCollection 2023 Dec.
To compare tomosynthesis performance to radiography for the differentiation of sacroiliitis versus normal or degenerative changes in sacroiliac joints in patients with suspected axial spondyloarthritis (SpA).
Radiography, tomosynthesis and CT of sacroiliac joints (29 patients) were performed on the same day in consecutive patients with suspected SpA. The examinations were retrospectively read independently, blinded by two radiologists (one junior and one senior, and twice by one junior). Interobserver and intraobserver agreement was evaluated using the kappa coefficient. Effective doses for each imaging sensitivity, specificity and accuracy were assessed and compared with CT as gold standard.
CT detected 15/58 joints with sacroiliitis. The imaging sensitivity, specificity and accuracy were 60%, 84% and 44%, respectively, for radiography and 87%, 91% and 77% for tomosynthesis. The mean effective dose for tomosynthesis was significantly lower than that of CT (5-fold less) and significantly higher than that of radiography (8-fold more).
Tomosynthesis is superior to radiography for sacroiliitis detection in patients with suspected SpA, with 5-fold less radiation exposure than CT.
比较断层合成成像与X线摄影在疑似轴性脊柱关节炎（SpA）患者中鉴别骶髂关节炎与骶髂关节正常或退变改变的性能。
对连续的疑似SpA患者（29例）在同一天进行骶髂关节的X线摄影、断层合成成像及CT检查。由两名放射科医生（一名初级和一名高级，其中一名初级医生阅片两次）对检查结果进行独立的回顾性阅片，阅片时设盲。采用kappa系数评估观察者间及观察者内一致性。评估每种成像的敏感性、特异性和准确性的有效剂量，并与作为金标准的CT进行比较。
CT检测出15/58个骶髂关节炎关节。X线摄影的成像敏感性、特异性和准确性分别为60%、84%和44%，断层合成成像分别为87%、91%和77%。断层合成成像的平均有效剂量显著低于CT（低5倍），显著高于X线摄影（高8倍）。
在疑似SpA患者中，断层合成成像在骶髂关节炎检测方面优于X线摄影，且辐射暴露比CT少5倍。
