不同方法测量尺骨变异的对比研究  

Comparative study of ulnar variance measurements by different methods

作　　者：孙成[1] 步建立[1] 王江涛[1] 钱宇航[1] 尹豫[1] 车建伟[1] 

机构地区：[1]中国人民解放军白求恩国际和平医院骨二科,河北石家庄050082

出　　处：《河北医科大学学报》2017年第7期774-777,781,F0003,共6页Journal of Hebei Medical University

摘　　要：目的比较X线、CT、磁共振成像(magnetic resonance imaging,MRI)测量尺骨变异(ulnar variance,UV)的可靠性和一致性。方法招募32例志愿者均行双腕后前位X线、侧位X线、CT及MRI检查,分别应用后前位X线平片、侧位X线片、冠状位CT多平面重建、矢状位CT多平面重建、CT三维重建、冠状位MRI(骨-骨)、冠状位MRI(软骨-软骨)测量其UV。采用多组比较的秩和检验比较同一测量者使用7种方法测量UV的差异,以组内相关系数(Intraclass correlation coefficient,ICC)评估7种方法的可靠性,以Bland-Altman图评估测量的一致性。结果同一测量者使用7种方法测量UV的差异无统计学意义(P>0.05)。7种方法测量UV均具有较高的测量者内ICC及测量者间ICC,其中CT三维重建法的测量者内ICC及测量者间ICC最高、一致性最好。结论后前位X线片、侧位X线片、冠状位CT多平面重建、矢状位CT多平面重建、CT三维重建、冠状位MRI(软骨-软骨)和MRI(骨-骨)均可用于测量UV,其中CT三维重建法测量UV的可靠性最好、一致性最高,较其他6种方法测量UV更精确。Objective To compare the agreement and reliability of ulnar variance measurements on radiograph, computed tomography（CT）, magnetic resonance imaging（MRI）.Methods Thirty-two volunteers who underwent wrists posteroanterior and lateral X-ray, X-ray, CT and MRI were recruited.The differences in ulnar variance measured with different methods were evaluated with Kruskal-Wallis H analysis of variances.Intraclass correlation coefficient（ICC） was used to assess the repeatability of seven methods, and agreement between raters and methods were compared using Bland-Altman plots.Results There was no significant difference in ulnar variance measured by seven methods（P〉0.05）.Inter-rater and intra-rater ICC were both using excellently in all 7 methods.The CT three-dimensional reconstruction was outstanding in reliability and agreement.Conclusion PA radiography, lateral radiography, coronal CT multiplanar reconstruction, sagittal CT multiplanar reconstruction, CT three-dimensional reconstruction, coronal MRI（bone-bone）and coronal MRI（cartilage-cartilage）, all the methods mentioned above could be used in measuring the UV.CT 3D reconstruction method was the most reliable and consistent method for measuring UV, which was more accurate than other 6 methods for measuring UV.

关 键 词：尺骨 遗传变异 磁共振成像 

分 类 号：R323.71[医药卫生—人体解剖和组织胚胎学]