CT三维重建评价椎弓根螺钉位置分级的可信度分析  

CT three-dimensional reconstruction evaluates pedicle screw position classification: reliability analysis

作　　者：颜冰珊[1] 尹望平[1] 倪妙忠[1] 陈延超[1] 董加纯[1] 

机构地区：[1]复旦大学附属金山医院骨科,上海市200540

出　　处：《中国组织工程研究》2015年第44期7172-7176,共5页Chinese Journal of Tissue Engineering Research

基　　金：复旦大学附属金山医院资助课题(2013-8)~~

摘　　要：背景:近年来已逐步采用CT来评价椎弓根螺钉位置,但是对应用CT三维重建评价椎弓根螺钉位置的可信度报道较少。目的:探讨应用CT三维重建评价椎弓根螺钉位置分级的可信度。方法:收集了27例椎弓根螺钉置入患者,置入后1周内行CT扫描,由2位专业骨科主治医师随机观察CT二维和三维影像资料,根据Rao分级方法对螺钉位置进行分级,利用一致性检验来评价观察者间信度和观察者自身信度。结果与结论:27例患者共置入椎弓根螺钉116枚。利用二维CT图像资料,对螺钉位置分级的判定观察者间信度和观察者自身信度均为高度一致,Kappa系数分别为0.656和0.631。利用三维重建CT图像资料,对螺钉位置分级的判定观察者间信度和观察者自身信度均为最强,Kappa系数分别为0.833和0.863。说明CT三维重建在评价椎弓根螺钉位置的可信度较高,具有一定的临床应用价值。BACKGROUND： In recent years, CT has been gradually adopted to evaluate the pedicle screw position, but there are less reports about the reliability of the application of CT three-dimensional reconstruction evaluating pedicle screw position. OBJECTIVE： To investigate the reliability of the application of CT three-dimensional reconstruction evaluating pedicle screw position classification. METHODS： Twenty-seven patients with pedicle screw placement were included. CT scan was conducted within one week after embedding. Two-dimensional and three-dimensional CT image data were randomly observed by two professional orthopedists. Screw position was performed classification according to Rao Grading method. Interobserver reliability and intraobserver reliability were evaluated using consistency test. RESULTS AND CONCLUSION： One hundred and sixteen pedicle screws were inserted in 27 patients. The grading determination of the screw position using two-dimensional CT images showed that the interobserver reliability and intraobserver reliability were highly consistent. Kappa coefficients were respectively 0.656 and 0.631. The grading determination of the screw position using three-dimensional reconstruction CT images showed that the interobserver reliability and intraobserver reliability were both strongest. Kappa coefficients were respectively 0.833 and 0.863. These results show that the reliability of applying CT three-dimensionalreconstruction on evaluating pedicle screw position is high, which proves a certain clinical application value.

关 键 词：骨科植入物 脊椎植入物 椎弓根 CT三维重建 胸椎 腰椎 内固定 观察者间信度 观察者自身信度 分级 KAPPA值 

分 类 号：R318[医药卫生—生物医学工程]