Reliability of Low-dose Biplanar Radiography in Assessing Pediatric Torsional Pathology
| Autor: | Andrew T. Pennock, Megan E Jeffords, Christine L. Farnsworth, Vidyadhar V. Upasani, Jaysson T. Brooks, James D. Bomar |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Pathology medicine.medical_specialty Intraclass correlation Radiography Dystonia Musculorum Deformans Cohort Studies 03 medical and health sciences Imaging Three-Dimensional 0302 clinical medicine Image Processing Computer-Assisted medicine Humans Orthopedics and Sports Medicine Femur Tibia Child 030222 orthopedics medicine.diagnostic_test business.industry Low dose Reproducibility of Results Torsion (mechanics) Magnetic resonance imaging General Medicine Radiation Exposure musculoskeletal system Magnetic Resonance Imaging Biplanar radiography Pediatrics Perinatology and Child Health Female Tomography X-Ray Computed business |
| Zdroj: | Journal of Pediatric Orthopaedics. 41:33-39 |
| ISSN: | 0271-6798 |
| DOI: | 10.1097/bpo.0000000000001700 |
| Popis: | Background Low-dose biplanar radiographs (LDBRs) significantly reduce ionizing radiation exposure and may be of use in evaluating lower extremity torsion in children. In this study, we evaluated how well femoral and tibial torsional profiles obtained by LDBR correspond with 3-dimensional (3D) computed tomography (CT) and magnetic resonance axial imaging (MRI) in pediatric patients with suspected rotational abnormalities. Methods Patients who had both LDBR and CT/MRI studies performed for suspected lower extremity rotational deformities were included. Unlike previous publications, this study focused on patients with lower extremity torsional pathology, and bilateral lower extremities of 17 patients were included. CT/MRI torsion was measured using the Reikeras method, after conversion to 3D reconstructions. The LDBRs were deidentified and sent to the software division of EOS imaging, who created 3D reconstructions and evaluated each reconstruction for the torsional quantification of the femurs and tibiae. These imaging modalities were compared using correlation statistics and Bland-Altman analyses. Results The mean age of the cohort was 12.1±1.7 years old. Torsional values of the femur were significantly lower in LDBRs versus 3D CT/MRIs at 17.7±15.1 and 23.3±17.3, respectively (P=0.001). Torsional values of the tibia were similar in LDBRs versus 3D CT/MRIs at 23.6±10.6 and 25.3±11.2, respectively (P=0.503). There was a good intermodality agreement between LDBR and 3D CT/MRI torsional values in the femur (intraclass correlation coefficient=0.807) and tibia (intraclass correlation coefficient=0.768). Bland-Altman analyses showed a fixed bias with a mean difference of -5.6±8.8 degrees between femoral torsion measurements in LDBRs versus 3D CT/MRIs (P=0.001); 15% (5/34) of femurs had a clinically significant measurement discrepancy. Fixed bias for LDBR measurements compared with 3D CT/MRIs for the tibia was not observed (P=0.193), however, 12% (4/34) of tibias had a clinically significant measurement discrepancy. Conclusion Although we found strong correlations between torsional values of the femur and tibia measured from LDBRs and 3D CT/MRIs, torsional values of the femur produced from LDBRs were significantly lower than values obtained from 3D CT/MRIs with some notable outliers. Level of evidence Level III. |
| Databáze: | OpenAIRE |
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