青少年特发性脊柱侧凸Cobb角计算机自动化测量准确性分析

Accuracy of computer automatic measurement of Cobb angle in adolescent idiopathic scoliosis patients

目的:分析青少年特发性脊柱侧凸(AIS)患者脊柱全长前后位X线片采用计算机自动化测量Cobb角的准确性。方法:回顾性收集2018年7月至2019年7月收治的36例经手术治疗的AIS患者脊柱全长前后位X线片。采用计算机建模对脊柱全长前后位X线片进行自动化测量。将计算机自动化测量的Cobb角与对脊柱畸形具有丰富经验的脊柱外科医师进行人工手动测量的结果进行比较。结果:36例AIS患者计算机自动化测量的Cobb角为31°~75°,平均(48.3±9.4)°;人工手动测量的Cobb角为36°~79°,平均(49.5±9.7)°,计算机自动化测量Cobb角准确性的组内相关系数(ICC)为0.913(P<0.001)。18例胸弯组患者计算机自动化测量与人工手动测量的平均Cobb角分别为(47.3±7.7)°和(47.6±8.3)°,ICC为0.945(P<0.001)。18例腰弯组患者计算机自动化测量与人工手动测量的平均Cobb角分别为(49.4±11.0)°和(51.3±10.8)°,ICC为0.897(P<0.001)。结论:AIS患者Cobb角计算机自动化测量结果与脊柱外科医师人工手动测量结果一致,侧凸顶点位于胸椎/腰椎均具有较高的准确性。

Objective:To analyze the accuracy of computer-aided automated measurement of Cobb angle in adolescent idiopathic scoliosis(AIS)patients.Methods:Anterior-posterior whole spinal X-ray films of 36 AIS patients treated surgically from July 2018 to July2019 were collected.The Cobb angles of the curves were measured by computer through previously trained model.The Cobb angles measured by computer were compared with the results measured manually by experienced spine surgeons.Results:The mean Cobb angle was 48.3°±9.4°(range,31°-75°)by computer measurement and 49.5°±9.7°(range,36°-79°)by manual measurement in the 36 patients.The intraclass correlation coefficient(ICC)for the reliability of the automated measurement of the Cobb angle was 0.913(P<0.001).The mean Cobb angle was 47.3°±7.7°by computer measurement and 47.6°±8.3°by manual measurement in the 18 patients with thoracic curve,with an ICC of 0.945(P<0.001).The mean Cobb angle was 49.4°±11.0°by computer measurement and 51.3°±10.8°by manual measurement in the 18 patients with lumbar curve,with an ICC of 0.897(P<0.001).Conclusions:The computer automated measurement of Cobb angle in AIS patients is consistent with manual measurement.It has a high accuracy no matter the curve is located at thoracic vertebrae or lumbar vertebrae.