中国组织工程研究

中国组织工程研究 ›› 2015, Vol. 19 ›› Issue (44): 7172-7176.doi: 10.3969/j.issn.2095-4344.2015.44.022

• 骨与关节生物力学 bone and joint biomechanics • 上一篇    下一篇

CT三维重建评价椎弓根螺钉位置分级的可信度分析

颜冰珊，尹望平，倪妙忠，陈延超，董加纯   

  1. 复旦大学附属金山医院骨科，上海市 200540
  • 收稿日期:2015-09-13 出版日期:2015-10-22 发布日期:2015-10-22
  • 通讯作者: 尹望平，复旦大学附属金山医院骨科，上海市 200540
  • 作者简介:颜冰珊，男，1981年生，福建省莆田市人，汉族，2009年复旦大学毕业，硕士，主治医师，主要从事四肢与脊柱创伤研究。
  • 基金资助:

    复旦大学附属金山医院资助课题(2013-8)

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

Yan Bing-shan, Yin Wang-ping, Ni Miao-zhong, Chen Yan-chao, Dong Jia-chun   

  1. Department of Orthopedics, Jinshan Hospital, Fudan University, Shanghai 200540, China
  • Received:2015-09-13 Online:2015-10-22 Published:2015-10-22
  • Contact: Yin Wang-ping, Department of Orthopedics, Jinshan Hospital, Fudan University, Shanghai 200540, China
  • About author:Yan Bing-shan, Master, Attending physician, Department of Orthopedics, Jinshan Hospital, Fudan University, Shanghai 200540, China
  • Supported by:

    a project funded by Jinshan Hospital of Fudan University of China, No.2013-8

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430

被引次数

1

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。
中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

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

Abstract:

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-dimensional reconstruction on evaluating pedicle screw position is high, which proves a certain clinical application value.
中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Internal Fixators, Image Processing, Computer-Assisted, Thoracic Vertebrae, Lumbar Vertebrae, Tissue Engineering