【摘要】 目的对比EOS与CT在不同体位、不同角度下的股骨标本和实体受试者股骨颈前倾角(FNA)测量中的临床意义。方法对20个风干股骨标本在中立位不同角度(5°、10°、15°)的伸位、曲位、外旋位、内旋位、外展位、内收位上分别行EOS和CT检查,并对36例同期接受髋关节EOS和CT检查的患者或正常人临床资料进行回顾性分析。2名诊断医师独立测量FNA,t检验评估不同股骨位置对FNA测量结果的影响,一致性分析评估其可靠性,线性回归分析确定其相关性,Bland-Altman图评估CT、EOS差异。结果在股骨标本中,EOS在不同体位、不同角度测量所得的FNA均无明显差异; CT在伸位、内旋位测量所得的FNA随伸展角度及内旋角度增大而增加(P <0.05),在曲位、外旋位测量所得的FNA随曲屈角度及外旋角度增大而减小(P <0.05),在不同角度外展位、内收位测量所得的FNA无明显差异(P> 0.05); CT、EOS在测量FNA上一致性均良好。在实体受试者中,采用EOS和CT测量的FNA结果无统计学差异,一致性分析结果显示,EOS可靠性为良好,CT可靠性为一般。结论在股骨标本各种体位15°以内EOS与CT均可以提供稳定且可重复的FNA测量结果,在实体受试者中EOS的FNA测量结果较CT更为稳定、可靠,同时辐射量更小,可以替代CT为临床提供更精确的结果,是一种更稳定、更安全的检测方法。更多还原

【Abstract】 Objective To compare the clinical significance of EOS and CT in the measurement of femoral neck anteversion( FNA) of femoral specimens and human subjects in different positions and angles. Methods Twenty air-dried femoral specimens were examined by EOS and CT at different angles( 5°,10°,15°) in neutral position in extension,flexion,external rotation,internal rotation,abduction,and adduction,respectively. The clinical data of 36 patients or healthy subjects who received EOS and CT examination of the hip joint were retrospectively analyzed. Two diagnostic physicians independently measured the FNA,t-test was used to evaluate the impact of different femoral positions on the FNA measurement results,consistency analysis was used to evaluate the reliability,linear regression analysis was used to determine the correlation,and Bland-Altman plot was used to evaluate the differences between CT and EOS. Results In femoral specimens,the FNA measured by EOS at different positions and angles showed no significant difference. In the CT measurement of the femoral specimens,the FNA measured in extension and internal rotation increased with the increase of extension angle and internal rotation angle( P < 0. 05); the FNA measured in flexion and external rotation decreased with the increase of flexion angle and external rotation angle( P < 0. 05); and there was no significant difference in the FNA measured at different abduction and adduction angles( P > 0. 05). The consistency of CT and EOS in measuring FNA was good. In human subjects,there was no statistically significant difference between the FNA results measured by EOS and CT. The consistency analysis showed that the reliability of EOS was good and the reliability of CT was moderate. Conclusion Both EOS and CT can provide stable and repeatable FNA measurement results in various positions of femoral samples within 15°. In human subjects,the FNA measurement results of EOS are more stable and reliable than CT,and the amount of radiation is less at the same time. It can replace CT to provide more accurate clinical results,and it is a more stable and safer detection method.更多还原