郝定均;杨俊松;拓源;葛朝元;贺宝荣;刘团江;单乐群;黄大耿;贾帅军;刘鹏;陈浩;

• 1:西安交通大学附属红会医院脊柱病医院

摘要(Abstract)：

[目的]针对慢性症状性骨质疏松性胸腰椎骨折(chronic symptomatic osteoporotic thoracolumbar fracture,CSOTF),本研究提出了一种全新的基于骨折影像学特点的分型体系,并对其可信度进行了检验。[方法]回顾性分析2010年1月～2017年6月本院收治的368例具有完整影像资料的CSOFT患者,影像学检查包括腰椎正侧位及过屈过伸位X线片、CT和MRI。根据影像学上伤椎是否存在失稳、椎管是否合并狭窄和有无后凸畸形三个关键特征,将CSOTF分为I型(动态稳定型)、II型(动态不稳型)、III型(椎管狭窄型)、IV型(后凸畸形型),V型(混合型)。随机抽取40例患者,由10名医生按照上述分型体系对患者进行分型评估,并在初次评估1个月后再进行第二次评估,计算测量者间信度(interobserver reliability)与测量者内信度(intraobserver reliability)。[结果]在368例CSOTF患者中,I型最多,占55.71%;V型最少,占5.99%。对40例CSOTF患者的分型评估,测量者间可信度的总体κ值为0.834,表明CSOTF影像学分型一致性好;测量者内可信度的总体κ值为0.853,表明两轮评估的重复性好。[结论]本研究表明CSOFT影像学分型,分类简单,一致性与重复性好,有利于临床评估与信息沟通。

关键词(KeyWords)： 骨质疏松性胸腰椎骨折;影像;分类;一致性;重复性

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金重点项目（编号：81830077）

作者(Author): 郝定均;杨俊松;拓源;葛朝元;贺宝荣;刘团江;单乐群;黄大耿;贾帅军;刘鹏;陈浩;

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