计算机光学地形图和视频光栅立体图在小学生脊柱侧凸诊断能力筛查中的比较

V. N. Sarnadskiy, D. Y. Batorov, O. A. Shchuchkina
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The obtained statistics on the distribution of topographic analogs of the Cobb angle (the angle of lateral asymmetry for TODP and the angle of scoliosis for Formetric) showed a significant discrepancy in the percentage of detected scoliosis cases: 0–5° – 50,0 % (TODP) and 4.1 % (Formetric); 5–7° – 33.8 % and 9.3 %; 7–9° – 12.4 % and 17.9 %; 9–15° – 3.8 % and 51.6 %; 15–25° – 0,0 % and 16.2 %; 25–50° – 0,0 % and 0.8 %, respectively. Clinically significant cases of scoliosis (9° or more) in the age groups was 3.7 %, 2.2 %, 6.6 % (mean – 3.8 %) for TODP and 71.1 %, 70.1 %, 63.2 % (average – 68.7 %) for Formetric. At the same time, only 14 cases of clinically significant scoliosis (from 9° to 15°), including 9 structural and 5 compensatory scoliosis, were detected by TODP, and 250 scoliosis cases (188 – from 9° to 15°, 59 – from 15° to 25°, 3 – from 25° to 37°) – by Formetric. For 9 structural scoliosis cases (according to TODP), the Formetric diagnosis coincided completely only in 2 cases and  partially in 3 (55 %), and in 5 cases of compensatory scoliosis (according to TODP) it coincided completely in 3 cases and partially in 1 (80 %).Conclusion. According to the results of topographic screening of 364 schoolchildren using the TODP topograph, 3.8 % of scoliosis cases of 9° or more was detected, which corresponds to the average screening data in a number of countries around the world. 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To analyze the results of scoliosis diagnostics during the examination of the same group of schoolchildren by TODP and Formetriс topographs.Material and Methods. A total of 364 schoolchildren (197 girls and 167 boys, mean age 8.92 ± 1.9 years) were examined, divided into 3 age groups: 6–8 years old (n = 135, mean age 7.22 ± 0.7 years), 8–10 years old (n = 134 children, mean age 8.95 ± 0.56 years), 10–12 years old (n = 95 children, mean age 11.35 ± 1.59 years). Schoolchildren were examined in turn by computer optical topography (TODP, released in 2021, WTOPO 5.4-2021 software) and video raster stereography (Formetric 4D released in 2015, DICAM2.6.4 software). Three standard screening poses were used for TODP, and one pose with averaging 12 frames – for Formetric.Results. The obtained statistics on the distribution of topographic analogs of the Cobb angle (the angle of lateral asymmetry for TODP and the angle of scoliosis for Formetric) showed a significant discrepancy in the percentage of detected scoliosis cases: 0–5° – 50,0 % (TODP) and 4.1 % (Formetric); 5–7° – 33.8 % and 9.3 %; 7–9° – 12.4 % and 17.9 %; 9–15° – 3.8 % and 51.6 %; 15–25° – 0,0 % and 16.2 %; 25–50° – 0,0 % and 0.8 %, respectively. Clinically significant cases of scoliosis (9° or more) in the age groups was 3.7 %, 2.2 %, 6.6 % (mean – 3.8 %) for TODP and 71.1 %, 70.1 %, 63.2 % (average – 68.7 %) for Formetric. At the same time, only 14 cases of clinically significant scoliosis (from 9° to 15°), including 9 structural and 5 compensatory scoliosis, were detected by TODP, and 250 scoliosis cases (188 – from 9° to 15°, 59 – from 15° to 25°, 3 – from 25° to 37°) – by Formetric. 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引用次数: 0

摘要

目标。目的分析TODP和formtrir地形图对同一组小学生脊柱侧凸的诊断结果。材料和方法。共调查在校生364人,其中女生197人,男生167人,平均年龄8.92±1.9岁,分为6-8岁(135人,平均年龄7.22±0.7岁)、8-10岁(134人,平均年龄8.95±0.56岁)、10-12岁(95人,平均年龄11.35±1.59岁)3个年龄组。学生们依次通过计算机光学地形(TODP, 2021年发布,WTOPO 5.4-2021软件)和视频光栅立体(2015年发布的Formetric 4D, DICAM2.6.4软件)进行检查。三个标准的筛选姿势用于TODP,一个姿势平均为12帧-用于formmetric结果。对Cobb角(TODP的侧不对称角和Formetric的脊柱侧凸角)的地形类似物的分布进行统计,发现脊柱侧凸病例的百分比有显著差异:0 - 5°- 50.0% (TODP)和4.1% (Formetric);5-7°- 33.8%和9.3%;7-9°- 12.4%和17.9%;9-15°- 3.8%和51.6%;15-25°- 0,0 %和16.2%;25-50°- 0、0 %和0.8 %。TODP组的脊柱侧凸(9°或以上)临床显著性病例为3.7%、2.2%、6.6%(平均- 3.8%),formmetric组为71.1%、70.1%、63.2%(平均- 68.7%)。同时,TODP仅检测出14例具有临床意义的脊柱侧凸(9°~ 15°),其中结构性侧凸9例,代偿性侧凸5例;Formetric检测出250例(9°~ 15°侧凸188例,15°~ 25°侧凸59例,25°~ 37°侧凸3例)。9例结构性侧凸(按TODP)中,Formetric诊断完全吻合2例,部分吻合3例(55%),代偿性侧凸(按TODP) 5例完全吻合3例,部分吻合1例(80%)。根据使用TODP地形图对364名学童进行地形筛查的结果,检测到9°及以上脊柱侧凸病例的3.8%,这与世界上许多国家的平均筛查数据相对应。使用formmetric地形图对同一学童进行检查,发现68.7%的9°或以上的脊柱侧凸病例,这使我们能够判断是否过度诊断,并得出formmetric不适合学童脊柱侧凸地形筛查的结论。
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Comparison of scoliosis diagnostic capabilities in screening of schoolchildren by computer optical topography and video rasterstereography using TODP and Formetric topographs
Objective. To analyze the results of scoliosis diagnostics during the examination of the same group of schoolchildren by TODP and Formetriс topographs.Material and Methods. A total of 364 schoolchildren (197 girls and 167 boys, mean age 8.92 ± 1.9 years) were examined, divided into 3 age groups: 6–8 years old (n = 135, mean age 7.22 ± 0.7 years), 8–10 years old (n = 134 children, mean age 8.95 ± 0.56 years), 10–12 years old (n = 95 children, mean age 11.35 ± 1.59 years). Schoolchildren were examined in turn by computer optical topography (TODP, released in 2021, WTOPO 5.4-2021 software) and video raster stereography (Formetric 4D released in 2015, DICAM2.6.4 software). Three standard screening poses were used for TODP, and one pose with averaging 12 frames – for Formetric.Results. The obtained statistics on the distribution of topographic analogs of the Cobb angle (the angle of lateral asymmetry for TODP and the angle of scoliosis for Formetric) showed a significant discrepancy in the percentage of detected scoliosis cases: 0–5° – 50,0 % (TODP) and 4.1 % (Formetric); 5–7° – 33.8 % and 9.3 %; 7–9° – 12.4 % and 17.9 %; 9–15° – 3.8 % and 51.6 %; 15–25° – 0,0 % and 16.2 %; 25–50° – 0,0 % and 0.8 %, respectively. Clinically significant cases of scoliosis (9° or more) in the age groups was 3.7 %, 2.2 %, 6.6 % (mean – 3.8 %) for TODP and 71.1 %, 70.1 %, 63.2 % (average – 68.7 %) for Formetric. At the same time, only 14 cases of clinically significant scoliosis (from 9° to 15°), including 9 structural and 5 compensatory scoliosis, were detected by TODP, and 250 scoliosis cases (188 – from 9° to 15°, 59 – from 15° to 25°, 3 – from 25° to 37°) – by Formetric. For 9 structural scoliosis cases (according to TODP), the Formetric diagnosis coincided completely only in 2 cases and  partially in 3 (55 %), and in 5 cases of compensatory scoliosis (according to TODP) it coincided completely in 3 cases and partially in 1 (80 %).Conclusion. According to the results of topographic screening of 364 schoolchildren using the TODP topograph, 3.8 % of scoliosis cases of 9° or more was detected, which corresponds to the average screening data in a number of countries around the world. Examination of the same schoolchildren using the Formetric topograph revealed 68.7 % of cases of scoliosis of 9° or more, which allows us to judge about overdiagnosis and conclude that Formetric is poorly suited for topographic screening of scoliosis in schoolchildren.
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