Castellvi classification of lumbosacral transitional vertebrae: comparison between conventional radiography, CT, and MRI.

IF 1.1 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Acta radiologica Pub Date : 2024-10-24 DOI:10.1177/02841851241289355
Jaakko Hanhivaara, Juhani H Määttä, Pietari Kinnunen, Jaakko Niinimäki, Mika T Nevalainen
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Abstract

Background: The reliability and diagnostic accuracy of commonly used diagnostic imaging modalities in the classification of lumbosacral transitional vertebrae (LSTV) are poorly known, and comparative studies are scarce.

Purpose: To compare the diagnostic performance of conventional radiography (CR), computed tomography (CT), and magnetic resonance imaging (MRI) in classifying LSTVs.

Material and methods: In this retrospective cross-sectional study, a total of 852 patients undergoing lumbar imaging studies using all three modalities were initially assessed for the presence of LSTV using CT scans. In total, 100 patients with LSTV anatomy were identified. Four readers performed blinded and independent evaluations of these 100 patients on each modality, and an experienced fellowship-trained radiologist performed a gold standard read using all three modalities. Inter-reader reliability metrics were analyzed in comparison to the gold standard. Statistical software R (4.2.1) was used for the analyses.

Results: We found superior diagnostic efficacy for CT: the sensitivity, specificity, accuracy, and balanced accuracy were 76%, 93%, 77%, and 84%, respectively. For MRI, the metrics were 54%, 88%, 56%, and 68%, and for CR 32%, 85%, 42%, and 59%, respectively. Inter-reader reliability was found to be good for CT (κ = 0.63-0.71) and fair for both CR (κ = 0.16-0.32) and MRI (κ = 0.24-0.56).

Conclusion: CT had the highest diagnostic performance in all measured metrics with good inter-reader reliability. MRI and CR showed fairly poor sensitivity and accuracy, and thus consideration should be used when classifying LSTVs with these two modalities.

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腰骶部过渡椎体的 Castellvi 分类:传统放射摄影、CT 和 MRI 之间的比较。
背景:目的:比较传统放射摄影(CR)、计算机断层扫描(CT)和磁共振成像(MRI)在腰椎过渡椎体(LSTV)分类中的诊断性能:在这项回顾性横断面研究中,共有 852 名患者接受了腰椎造影检查,这三种检查方式均使用 CT 扫描对是否存在 LSTV 进行初步评估。共有 100 名患者被确定为 LSTV。四名读片员分别使用每种模式对这 100 名患者进行了盲法独立评估,一名经验丰富、受过研究培训的放射科医生使用所有三种模式进行了金标准读片。通过与金标准进行比较,分析了读片者之间的可靠性指标。分析使用了 R(4.2.1)统计软件:我们发现 CT 的诊断效果更佳:灵敏度、特异性、准确性和平衡准确性分别为 76%、93%、77% 和 84%。MRI 的指标分别为 54%、88%、56% 和 68%,CR 的指标分别为 32%、85%、42% 和 59%。阅片员之间的可靠性在 CT 中为良好(κ = 0.63-0.71),在 CR(κ = 0.16-0.32)和 MRI(κ = 0.24-0.56)中为一般:结论:在所有测量指标中,CT 的诊断性能最高,阅片者之间的可靠性良好。结论:在所有测量指标中,CT 的诊断性能最高,阅片者之间的可靠性也很好。MRI 和 CR 的灵敏度和准确性较差,因此在使用这两种模式对 LSTV 进行分类时应加以考虑。
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来源期刊
Acta radiologica
Acta radiologica 医学-核医学
CiteScore
2.70
自引率
0.00%
发文量
170
审稿时长
3-8 weeks
期刊介绍: Acta Radiologica publishes articles on all aspects of radiology, from clinical radiology to experimental work. It is known for articles based on experimental work and contrast media research, giving priority to scientific original papers. The distinguished international editorial board also invite review articles, short communications and technical and instrumental notes.
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