髋关节骨性关节炎CT分级的可重复性研究  

The reproducibility of CT grading for hip osteoarthritis

作　　者：陈其春[1] 程晓光[2] 管松[1] 郑穗生[1,3] CHEN Qichun;CHENG Xiaoguang;GUAN Song;ZHENG Suisheng(Department of Radiology,the Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China;Department of Radiology,Beijing Jishuitan Hospital,Beijing 100035,China;Medical Imaging Research Center,Anhui Medical University,Hefei 230000,China)

机构地区：[1]安徽医科大学第二附属医院放射科,安徽合肥230601 [2]北京积水潭医院放射科,北京100035 [3]安徽医科大学医学影像研究中心,安徽合肥230000

出　　处：《实用放射学杂志》2018年第8期1235-1238,共4页Journal of Practical Radiology

基　　金：安徽省质量工程项目（2014jxtdll9）;安徽省校国际教育类教学研究项目（gjyxm201505）.

摘　　要：目的探讨CT对髋关节骨性关节炎（OA）评级的可重复性。方法回顾性分析61例（69个髋）髋关节OA患者的X线及CT资料，CT采用冠状面重建图像进行观察。由2位医师独立按照K／L及CT评级标准，对患侧髋关节骨赘及关节间隙情况等进行观察，并按严重程度分为O～4级，对结果进行一致性检验。结果K／L评级与CT评级一致性Kdppa值为0．725、0．742。2名医师利用CT评级组内及组间一致性Kappa值分别为0.854、0.833。2名医师CT评级与K／L评级间比较无显著性差异（P均〉0.05）。2组影像资料上测量最小关节间隙值之间一致性良好（ICC0.75）。结论髋关节OA的CT分级具有良好的可重复性，对髋关节退变程度的评估和研究有指导意义；CT能够替代X线作为髋关节OA影像学评级方法之一。Objective To investigate the reproducibility of CT grading for hip osteoarthritis（OA）.Methods The X-ray and CT data of 61 patients （69 hips） with hip OA were analyzed retrospectively.The coronal CT images were utilized to analyze.Depending on the K/L and CT grading criteria,osteophyte and joint space width of the hip with OA were independently assessed by two attending physicians. Hip joints were divided into 0-4 grades according to severity of OA, and the results were analyzed by the consistency test. Results Kappa value of K/L and CT grading consistency were 0.725 and 0.742 respectively. Intra-and inter-observer consistency for CT grading were excellent,and Kappa values were 0.854 and 0.833 respectively. There was no significant difference between the CT grading and K/L scores （P〉0.05）. The consistency of the minimum joint space width measured on the two types of images was good （ICC〉0.75）.Conclusion The CT grading for hip OA has substantial or excellent reproducibility,which has direct meaning for evaluation and research on the degree of hip degeneration.CT grading can replace X-ray as one of radiological evaluation of hip OA.

关 键 词：髋关节 骨性关节炎 CT分级 K/L评级标准 

分 类 号：R684.3[医药卫生—骨科学] R814.42[医药卫生—外科学]