基于EOS系统和CT系统测量青少年特发性脊柱侧凸顶椎旋转角度的对比观察

Comparison of apical vertebral rotation measurement of adolescent idiopathic scoliosis via EOS imaging and CT imaging

目的使用EOS影像系统与CT影像系统分别评估椎体旋转以探究顶椎位置对EOS测量结果的影响。方法2018年3月至2022年6月于北京积水潭医院住院治疗的青少年特发性脊柱侧凸(AIS)患者87例,年龄11~18(14.7±2.3)岁。共112个弯;其中胸弯61个,腰弯51个。统计一般资料,并进行影像学测量。在EOS影像中,三维拟合重建后获得Cobb角、顶椎旋转度(AVR)等参数。在CT影像中,采用Aaro-Dahlborn法测量AVR。根据侧凸位置的不同将所有侧凸分为胸椎组和腰椎组,并进行亚组分析,比较两组AVR的差异和相关性。结果87例AIS患者总体CT与EOS的测量结果差异无统计学意义(P=0.096);两者高度相关(r=0.771,P<0.001)。在胸椎组,EOS测量结果明显大于CT测量结果(P<0.001),两者中等相关(r=0.536,P<0.001)。在腰椎组,CT测量结果与EOS测量结果差异无统计学意义(P=0.193),两者高度相关(r=0.789,P<0.001),且其相关系数高于总体的相关系数。结论在顶椎旋转度的测量中,EOS全身影像系统和CT影像系统的测量结果无明显差异,且具有良好的相关性。在腰椎测量中类似,且相关性更高。但在胸椎中,EOS测量数据显著高于CT测量结果。

Objective To compare the spinal rotation measurement by EOS imaging and that by CT imaging,and to explore the influence of location on the apical vertebral rotation(AVR)measured by EOS imaging.Methods From March 2018 to June 2022,87 patients with adolescent idiopathic scoliosis(AIS)who were indicated for surgery in Department of Spine Surgery,Beijing Jishuitan Hospital,were enrolled.Eighty-seven consecutive AIS patients with 112 curves were identified,with age of 11-18(14.7±2.3)years old.General information was collected and radiographic measurements were performed.Apical vertebral rotation(AVR)was measured by EOS imaging(Fast 3D reconstruction by SterEOS)and CT imaging(Aaro-Dahlborn method)respectively.Cobb angle was automatically generated by EOS imaging too.All curves were separated into thoracic group and lumbar group according to the curve location.Then subgroup analysis was performed.Results In the whole data,there was no significant difference of AVR between EOS and CT(P=0.096).The high correlation was identified(r=0.771,P<0.001).In thoracic region significant difference was noted between them(P<0.001),and moderate correlation was identified(r=0.536,P<0.001).In lumbar region,no significant difference was noted between them(P=0.193),and higher correlation was found between them(r=0.789,P<0.001),and this was higher than the general correlation coefficient.Conclusion A good correlation was identified in the AVR measured by EOS imaging and by CT imaging,while differences did exist which was more obvious in thoracic region.In lumbar region,they correlated better and showed no significant difference.