Abstract：
OBJECTIVE: The diagnosis and classification of ossification of the posterior longitudinal ligament (OPLL) can be difficult with radiography alone; therefore, computed tomography (CT) is also usually performed. There are many reports on the usefulness of digital tomosynthesis (DTS) for image analysis in orthopedics. This study aimed to compare the accuracy of DTS with radiography and CT for the diagnosis and classification of cervical OPLL (C-OPLL).
METHODS: We included 31 patients with OPLL and 30 with cervical spondylotic myelopathy. The patients\' cervical spine radiography, DTS, and CT images were each evaluated twice by three specialists and three residents.
RESULTS: In the intra-observer reliability study, there was one observer with a fair level of kappa values for radiography and DTS among three residents. The kappa values for CT were the best for all observers. In the inter-observer reliability study, the interclass correlation coefficient (ICC) values were high for both diagnosis and classification by specialists at the almost perfect level for all three imaging modalities. On the other hand, the ICC values for both diagnosis and classification for radiography by the residents were lower than those for DTS and CT.
CONCLUSIONS: This study revealed that DTS may be an alternative to CT for the diagnosis and classification of C-OPLL by specialists. Caution should be exercised in diagnosing and classifying C-OPLL using radiography and DTS by residents, and the use of CT is recommended.
METHODS: We included 31 patients with OPLL and 30 with cervical spondylotic myelopathy. The patients\' cervical spine radiography, DTS, and CT images were each evaluated twice by three specialists and three residents.
RESULTS: In the intra-observer reliability study, there was one observer with a fair level of kappa values for radiography and DTS among three residents. The kappa values for CT were the best for all observers. In the inter-observer reliability study, the interclass correlation coefficient (ICC) values were high for both diagnosis and classification by specialists at the almost perfect level for all three imaging modalities. On the other hand, the ICC values for both diagnosis and classification for radiography by the residents were lower than those for DTS and CT.
CONCLUSIONS: This study revealed that DTS may be an alternative to CT for the diagnosis and classification of C-OPLL by specialists. Caution should be exercised in diagnosing and classifying C-OPLL using radiography and DTS by residents, and the use of CT is recommended.
摘要：
目的：后纵韧带骨化症（OPLL）的诊断和分类可能难以仅靠X线摄影；因此，计算机断层扫描（CT）也通常进行。关于数字断层合成（DTS）在骨科图像分析中的有用性，有许多报道。本研究旨在比较DTS与X线摄影和CT对宫颈OPLL（C-OPLL）诊断和分类的准确性。
方法：我们纳入了31例OPLL患者和30例脊髓型颈椎病患者。患者颈椎X线摄影，DTS,和CT图像分别由三名专家和三名居民进行两次评估。
结果：在观察者内部可靠性研究中，在3名居民中,有1名观察者的射线照相和DTS的kappa值处于相当水平.CT的kappa值对所有观察者都是最好的。在观察者间可靠性研究中，对于所有三种成像方式,专家诊断和分类的类间相关系数(ICC)值都很高,几乎达到完美水平.另一方面,居民X线摄影诊断和分类的ICC值均低于DTS和CT.
结论：这项研究表明，DTS可能是CT的替代方法，用于专家对C-OPLL的诊断和分类。居民应谨慎使用射线照相和DTS对C-OPLL进行诊断和分类，建议使用CT。
方法：我们纳入了31例OPLL患者和30例脊髓型颈椎病患者。患者颈椎X线摄影，DTS,和CT图像分别由三名专家和三名居民进行两次评估。
结果：在观察者内部可靠性研究中，在3名居民中,有1名观察者的射线照相和DTS的kappa值处于相当水平.CT的kappa值对所有观察者都是最好的。在观察者间可靠性研究中，对于所有三种成像方式,专家诊断和分类的类间相关系数(ICC)值都很高,几乎达到完美水平.另一方面,居民X线摄影诊断和分类的ICC值均低于DTS和CT.
结论：这项研究表明，DTS可能是CT的替代方法，用于专家对C-OPLL的诊断和分类。居民应谨慎使用射线照相和DTS对C-OPLL进行诊断和分类，建议使用CT。
