Guerra L E, Amato J A, Maher J F
Clin Nephrol. 1979 Jun;11(6):307-12.
Five radiologists graded 49 series of bone X-rays of 20 patients with chronic renal failure treated by hemodialysis. There was a high incidence of osteodystrophy which progressed identifiably over intervals exceeding 12 months. The severity grade of osteodystrophy was poorly reproducible among patients, among radiologists, and even between interpretations by the same radiologist after an interval of 10 months. Although the severity of osteodystrophy correlated with serum alkaline phosphatase values, the latter was not an accurate predictor of the severity of the bone lesions. Radiographic reassessment at intervals of one year or less in the asymptomatic patient has less reproducibility than the anticipated changes. More sensitive and reliable techniques are recommended.
五位放射科医生对20例接受血液透析治疗的慢性肾衰竭患者的49组骨骼X光片进行了分级。骨营养不良的发生率很高，且在超过12个月的时间段内有明显进展。骨营养不良的严重程度分级在患者之间、放射科医生之间，甚至在同一位放射科医生间隔10个月后的两次解读之间，再现性都很差。虽然骨营养不良的严重程度与血清碱性磷酸酶值相关，但后者并非骨病变严重程度的准确预测指标。对于无症状患者，每隔一年或更短时间进行的影像学重新评估，其再现性低于预期变化。建议采用更敏感、可靠的技术。
