摘要
目的探讨全脊柱X线拼接成像技术对脊柱侧弯诊断和脊柱柔韧性评估的应用价值。方法选择2018年1月至2021年12月于我院行脊柱侧弯筛查的300例患者作为研究对象,所有患者均于干预前行X线检查,并应用全脊柱X线拼接成像技术参考评估,确诊患者均予以手术方案治疗,且以脊柱侧弯手术治疗的专家共识指南作为金标准。分析全脊柱X线拼接成像技术对脊柱侧弯的检出率和诊断结果,Kappa一致性分析该技术对脊柱侧弯患者的诊断效能;比较拼接前后图像质量,分析不同体位全脊柱X线测量脊柱侧弯患者的差异。结果入组300例患者中,经金标准、全脊柱X线拼接成像技术诊断为脊柱侧弯患者分别为129例(43.00%)、133例(44.33%),经比较,差异无统计学意义(P>0.05)。全脊柱X线拼接成像技术诊断脊柱侧弯的灵敏度、特异性和Kappa值分别为90.70%、90.64%和0.862。129例患者中单胸椎侧弯82例,胸腰段侧弯47例。cobb角>60°、40°~60°、<40°分别有18、59和52例。拼接前、拼接后甲级、乙级与丙级图像质量比较,差异无统计学意义(P>0.05)。仰卧左右侧屈位检测cobb角明显小于站立正、侧位和悬吊正、侧位,侧弯柔韧性指数和矫正指数高于站立正、侧位和悬吊正、侧位,差异有统计学意义(P<0.05)。结论全脊柱X线拼接成像技术对脊柱侧弯有较高的诊断效能,可以用于评估判断脊柱侧弯的部位和侧弯程度,不会降低图像的原本质量,其中仰卧加压侧屈位成像更有利于准确评估脊柱柔韧性。
Objective To explore the application value of whole spine X-ray splicing imaging in the diagnosis of scoliosis and evaluation of spinal flexibility.Methods A total of 300 patients undergoing scoliosis screening in our hospital were enrolled as the research subjects from January 2018 to December 2021.All underwent X-ray examinations before intervention and were evaluated by whole spine X-ray splicing imaging.All confirmed patients were given surgical treatment.Taking expert consensus guidelines for surgical management of scoliosis as the golden standard,detection rate and diagnostic results of scoliosis by whole spine X-ray splicing imaging were analyzed.Its diagnostic efficiency for scoliosis was analyzed by Kappa consistency test.Images quality was compared before and after the splicing.The data differences in scoliosis patients with different positions were compared.Results In the 300 patients,the golden standard and whole spine X-ray splicing imaging showed that there were 129 cases(43.00%)and 133 cases(44.33%)with scoliosis,respectively.There was no significant difference between the two methods(P>0.05).The sensitivity,specificity and Kappa value of whole spine X-ray splicing imaging in the diagnosis off scoliosis were 90.70%,90.64%and 0.862,respectively.In the 129 patients,there were 82 cases with thoracic scoliosis and 47 cases with thoracolumbar scoliosis.There were 18,59 and 52 cases with cobb angle of>60°,40°~60°and<40°,respectively.Before and after splicing,there was no significant difference in quality of image at grades A,B and C(P>0.05).The cobb angle in patients with supine positions of left and right flexion status was significantly smaller than that with normal and side positions of standing and suspending status,scoliosis flexibility index and correction index were significantly higher than those with normal and side positions of standing and suspending status(P<0.05).Conclusion The whole spine X-ray splicing imaging has high diagnostic efficiency for scoliosis,which can be applied to determi
作者
赵莉
李德春
王光明
刘秋红
ZHAO Li;LI Dechun;WANG Guangming;LIU Qiuhong(Department of Radiology,Xuzhou Central Hospital,Xuzhou Jiangsu 221000,China)
出处
《中国医疗设备》
2022年第11期99-102,142,共5页
China Medical Devices
基金
江苏省妇幼保健协会科研项目(FYX201912)。
关键词
全脊柱X线拼接成像
仰卧加压侧屈位成像
脊柱侧弯
脊柱柔韧性
whole spine X-ray splicing imaging
imaging of supine compression lateral flexion position
scoliosis
spinal flexibility
