肛门直肠畸形骶椎侧位片与正位片测量骶骨指数的相关性研究  

Correlation between the lateral and anteroposterior sacral ratios in anorectal malformation

作　　者：姚艾杰 荀冲 郭斌[1] 李姝[1] 杨明[1] YAO Aijie;XUN Chong;GUO Bin;LI Shu;YANG Ming(Department of Radiology,the Children’s Hospital of Nanjing Medical University,Nanjing 210008,China)

机构地区：[1]南京医科大学附属儿童医院放射科,江苏南京210008

出　　处：《实用放射学杂志》2024年第4期625-628,共4页Journal of Practical Radiology

摘　　要：目的拟确定肛门直肠畸形(ARM)患者骶椎侧位片与正位片测量骶骨指数(SR)的相关性与一致性。方法回顾性分析ARM患者骶椎正位和侧位X线平片影像资料。由3名放射科医师测量所有患者的SR值。采用Pearson相关系数评估侧位X线平片和正位X线平片测量的SR之间的相关性。使用加权Kappa统计量衡量观察组SR值划分为危险组的一致性。结果385例ARM患者,排除25例X线平片成像质量不足以计算SR值的患者。配对正位测量的SR值与侧位测量的SR值,侧位SR值平均比正位SR值大0.08[95%置信区间(CI)0.06~0.09,P<0.01]。正位和侧位图像呈中度正相关(r=0.79,95%CI 0.73~0.79,P<0.01)和风险分类中度一致性(Kappa=0.62,P<0.01)。3位放射科医师进行的正位和侧位SR测量具有较好的评分者间可靠性,正位和侧位骶骨测量值的组内相关系数(ICC)分别为0.88和0.84。结论正位片骶骨SR值与侧位片骶骨SR值呈中度正相关,但侧位SR值比正位SR值平均大0.08。侧位片SR值和正位片SR值归纳风险类别具有差异性,骶椎侧位片较正位片所测SR值更具有临床意义。Objective To determine the correlation and agreement of sacral ratio(SR)measured by lateral and anteroposterior radiographs in patients with anorectal malformation(ARM).Methods A retrospective analysis was conducted on the anteroposterior and lateral radiographs images of the sacral vertebrae of patients with ARM.All SR values were measured by three radiologists.Pearson’s correlation coefficient were used to assess the correlation between the SR measured by lateral and anteroposterior radiographs.A weighted Kappa statistic was used to measure the agreement between how the anteroposterior and lateral SR categorized observations into risk groups.Results Of the 385 ARM patients,25 patients whose radiographs image quality was insufficient to calculate SR value were excluded.For a given pair of measurements,the mean lateral SR value was 0.08 units greater than the anteroposterior SR value[95%confidence interval(CI)0.06-0.09,P<0.01].Anteroposterior and lateral images had a moderate positive correlation(r=0.79,95%CI 0.73-0.79,P<0.01)and moderate agreement in risk categorization(Kappa=0.62,P<0.01).Anteroposterior and lateral readings conducted by all three radiologists had excellent inter-rater reliability with intraclass correlation coefficient(ICC)for anteroposterior and lateral SR of 0.88 and 0.84,respectively.Conclusion Even though the anteroposterior and lateral SR values have moderate positive correlation,the mean SR value determined by images in the lateral is 0.08 units greater than the anteroposterior.Anteroposterior and lateral SR value conclude different risk categories relatively often.The SR values measured by lateral sacral radiographs are more clinically significant than those measured by anteroposterior radiographs.

关 键 词：肛门直肠畸形 放射摄影术 儿童 骨盆 骶骨指数 

分 类 号：R574.8[医药卫生—消化系统] R814.41[医药卫生—内科学]