Objective To study the accuracy and reliability of EOSTM imaging system in the evaluation of adult scoliosis.Methods Between September 2015 and January 2016, EOS images from 41 adult scolisis patients ( 5 males, 36 females, mean age 64.6-year-old ) were collected for the study. SterEOS software was used to do 3 D reconstruction of the spine to obtain a set of measurements, including Cobb’s angle, apical vertebral rotation, T1-12 kyphosis, T4-12 kyphosis, L1-5 lordosis, L1 - S1 lordosis, pelvic incidence, sacral slope, sagittal pelvic tilt, lateral pelvic tilt and pelvis axial rotation. Two radiologists were blinded to each other to conduct 3 D software generated measurements from an EOS imaging system. They also scored the conformance of 3 D model and images. Intra-class correlation coefficients were compared to evaluate inter-observer variability. Patients were also classified to 3 groups according to Cobb’s angle to analyze conformance.Results Intra-class correlation coefifcients were 0.990, 0.911, 0.971, 0.972 and 0.949 (P < 0.01 ) for Cobb’s angle, apical vertebral rotation, T4-12 kyphosis, L1-5 lordosis and L1 - S1 lordosis, respectively. Only poor intra-class correlation coefifcient: 0.194 (P = 0.104 ) for T1-12 kyphosis. Intra-class correlation coefifcients were 0.846, 0.885, 0.914, 0.987 and 0.779 (P < 0.01 ) for pelvic incidence, sacral slope, sagittal pelvic tilt, lateral pelvic tilt and pelvis axial rotation. Conformation scores were statistically different among patients in 3 groups of different Cobb’s angles (F = 4.721,P = 0.015 ).Conclusions EOS imaging and sterEOS 3 D reconstruction create accurate and reliable measurements in adult scoliosis, providing a novel method for radiologists and orthopedists to improve the assessment of scoliosis.%目的:研究 EOS 影像系统在成人脊柱侧凸评价中的可靠性和准确性。方法选择2015年9月至2016年1月,于我院进行 EOS 影像摄片的脊柱侧凸患者共41例。其中男5例,女36例,平均年龄64.6岁。利用 sterEOS 软件三维模型重建获得脊柱侧凸的各个测量数值,包括:Cobb’s 角、顶点椎体轴面旋转角、T1~12后凸角、T4~12后凸角、L1~5前凸角、L1~S1前凸角、骨盆入射角和矢状面骨盆倾斜角、外侧骨盆移位以及骨盆轴面旋转度。由2名放射科医师分别独立重建,并共同对模型与影像契合度进行评分。利用观察者间变异系数评价2名医师测得数据的观察者间变异。同时根据 Cobb’s 角将患者分为3组,并分析各组间契合度评分有无差异。结果脊柱测量值中,Cobb’s 角、顶点椎体轴面旋转角、T4~12后凸角、L1~5前凸角和 L1~S1前凸角的观察者间组内相关系数( intraclass correlation coefficient,ICC )分别为0.990、0.911、0.971、0.972和0.949(P<0.01)。仅 T1~12后凸角的观察者间 ICC 较差,为0.194(P=0.104)。骨盆测量值中,骨盆入射角、骶骨倾斜角、矢状面骨盆倾斜角、外侧骨盆移位以及骨盆轴面旋转度的观察者间 ICC 分别为0.846、0.885、0.914、0.987和0.779(P<0.01)。3组 Cobb’s 角不同的患者模型契合度评分差异有统计学意义(F=4.721,P=0.015)。结论使用 EOS 系统摄片和 sterEOS 后处理软件对成人脊柱侧凸进行3 D 建模能获得很好的测量可靠性和准确性,为医师提供了一种全新的方法以更好地评判脊柱侧凸。
展开▼