A Comparative Study on the Consistency of Ultrasound and X-Ray in Assessing Risser Sign

IF 2.1 4区医学 Q2 ACOUSTICS

Journal of Ultrasound in Medicine Pub Date : 2024-10-08 DOI:10.1002/jum.16592

Lina Xue BMed, Xuehong Jiang BMed, Tao Shan MMed, Kai Wang BMed, Wei Zhou BMed, Xujie Wang MMed, Lili Zhu BMed, Bing Yu BMed, Ajun Wang MMed, Fenglin Dong MD

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引用次数: 0

Abstract

Objectives

Adolescent idiopathic scoliosis (AIS) is a 3-dimensional spinal deformity involving lateral curvature, sagittal plane imbalance, and vertebral rotation. In China, AIS affects over 3 million individuals, with 300,000 new cases annually. AIS impacts physical and psychological well-being, necessitating tailored treatment plans based on growth risk factors. This study evaluates the consistency of ultrasound and X-ray assessments of the Risser sign in AIS patients and explores correlations between iliac crest distance and pelvic rotation degree.

Methods

This prospective study enrolled 80 patients diagnosed with AIS from June to September 2023 at Changzhou Sports Hospital. Eligible participants were aged 10–18 with a Cobb angle >10°. Ultrasonographic examinations were conducted by 3 experienced physicians using the VINNO V10 portable ultrasound system. The primary outcome was the Risser stage determined by X-ray and ultrasound, with secondary outcomes including thoracic and thoracic-lumbar segment rotation angles. Statistical analyses included kappa statistics, correlation analyses, and multiple regression.

Results

Among the 77 valid cases, 154 iliac wings were evaluated, with a high concordance rate of 77% between ultrasound and X-ray assessments. kappa values for left and right iliac crests were 0.723 and 0.808, respectively. Grouping Risser grades (0–1, 2–3, and 4–5) into 3 categories yielded kappa values of 0.93, 0.96, and 0.93, indicating high consistency. Significant correlations were found between iliac crest distances and rotation angles (left iliac crest distance and left thoracic rotation angle, r = 0.56, P < .001; right iliac crest distance and right thoracic-lumbar rotation angle, r = 0.69, P < .001; right iliac crest distance and right thoracic rotation angle, r = 0.39, P < .01).

Conclusions

Ultrasound is a reliable, radiation-free alternative to X-ray for assessing the Risser sign in AIS patients. Despite observed inconsistencies in intermediate Risser grades, ultrasound's ability to reduce radiation exposure and provide consistent results makes it a valuable tool in clinical practice. Further research is needed to optimize ultrasound techniques and explore its potential for early detection and intervention in scoliosis management.

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超声波和 X 射线在评估里瑟征方面一致性的比较研究。

目的：青少年特发性脊柱侧弯（AIS）是一种涉及侧弯、矢状面不平衡和椎体旋转的三维脊柱畸形。在中国，AIS 患者超过 300 万，每年新增病例 30 万。AIS 影响着患者的生理和心理健康，因此需要根据生长风险因素制定有针对性的治疗方案。本研究评估了超声和X光对AIS患者Risser征评估的一致性，并探讨了髂嵴距离和骨盆旋转度之间的相关性：这项前瞻性研究招募了80名于2023年6月至9月在常州体育医院确诊的AIS患者。符合条件的患者年龄在 10-18 岁之间，Cobb 角大于 10°。由 3 名经验丰富的医生使用 VINNO V10 便携式超声系统进行超声检查。主要结果是通过X光和超声检查确定的Risser分期，次要结果包括胸椎和胸腰段旋转角度。统计分析包括卡帕统计、相关性分析和多元回归：在 77 个有效病例中，共评估了 154 个髂骨翼，超声和 X 光评估的吻合率高达 77%。将 Risser 分级（0-1、2-3 和 4-5）分为 3 类，得出的 kappa 值分别为 0.93、0.96 和 0.93，表明一致性很高。髂嵴距离和旋转角度之间存在显著相关性（左侧髂嵴距离和左侧胸廓旋转角度，r = 0.56，P 结论：在评估 AIS 患者的里瑟征时，超声是一种可靠、无辐射的 X 光替代方法。尽管观察到的中间瑞瑟分级不一致，但超声波能减少辐射暴露并提供一致的结果，因此在临床实践中是一种有价值的工具。需要进一步研究优化超声波技术，并探索其在脊柱侧弯管理中早期检测和干预的潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Ultrasound in Medicine 医学-核医学

CiteScore

5.10

自引率

4.30%

发文量

205

审稿时长

1.5 months

期刊介绍： The Journal of Ultrasound in Medicine (JUM) is dedicated to the rapid, accurate publication of original articles dealing with all aspects of medical ultrasound, particularly its direct application to patient care but also relevant basic science, advances in instrumentation, and biological effects. The journal is an official publication of the American Institute of Ultrasound in Medicine and publishes articles in a variety of categories, including Original Research papers, Review Articles, Pictorial Essays, Technical Innovations, Case Series, Letters to the Editor, and more, from an international bevy of countries in a continual effort to showcase and promote advances in the ultrasound community. Represented through these efforts are a wide variety of disciplines of ultrasound, including, but not limited to: -Basic Science- Breast Ultrasound- Contrast-Enhanced Ultrasound- Dermatology- Echocardiography- Elastography- Emergency Medicine- Fetal Echocardiography- Gastrointestinal Ultrasound- General and Abdominal Ultrasound- Genitourinary Ultrasound- Gynecologic Ultrasound- Head and Neck Ultrasound- High Frequency Clinical and Preclinical Imaging- Interventional-Intraoperative Ultrasound- Musculoskeletal Ultrasound- Neurosonology- Obstetric Ultrasound- Ophthalmologic Ultrasound- Pediatric Ultrasound- Point-of-Care Ultrasound- Public Policy- Superficial Structures- Therapeutic Ultrasound- Ultrasound Education- Ultrasound in Global Health- Urologic Ultrasound- Vascular Ultrasound