背景:我们旨在研究已知的二维(2D)和三维(3D)测量在负重计算机断层扫描(WBCT)中对进行性塌陷足畸形(PCFD)的诊断准确性。我们假设3D生物识别技术比2D测量对PCFD诊断具有更好的特异性和敏感性。
方法:这是一项回顾性病例对照研究,包括28只PCFD脚和28只年龄匹配的控件,性别和身体质量指数。二维测量包括:轴向和矢状距骨-第一跖骨角(TM1A和TM1S),距骨覆盖角(TNCA),前脚足弓角度(FFAA),中间刻面不一致角(MF°)和未覆盖百分比(MF%)。使用专用半自动软件获得3D足踝偏移(FAO)。评估了观察者内部和观察者之间的可靠性。计算受试者工作特征(ROC)曲线以确定诊断准确性(曲线下面积(AUC))。敏感性和特异性。
结果:在PCFD中,平均MF%和MF°分别为47.2%±15.4和13.3°±5.3,而对照组为13.5%±8.7和5.6°±2.9(p<0.001)。PCFD中的FAO为8.1%±3.8,对照组为1.4%±1.7(p<0.001)。MF%的AUC为0.99(95CI,0.98-1),粮农组织0.96(95CI,0.9-1),MF°为0.90(95CI,0.81-0.98)。对于MF%,阈值等于或大于28.7%的患者的敏感性为100%,特异性为92.8%.相反,FAO值等于或大于4.6%,特异性为100%,敏感性为89.2%.所有其他2D测量在PCFD和对照中显著不同(p<0.001)。
结论:MF%和FAO都是PCFD的准确测量值。MF%显示出略好的特异性。粮农组织更敏感。MF%的28.7%和FAO的4.6%的阈值组合产生100%的灵敏度和特异性。
BACKGROUND: We aimed to investigate the diagnostic accuracy of known two-dimensional (2D) and three-dimensional (3D) measurements for Progressive Collapsing Foot Deformity (PCFD) in weight-bearing computed tomography (WBCT). We hypothesized that 3D biometrics would have better specificity and sensitivity for PCFD diagnosis than 2D measurements.
METHODS: This was a retrospective
case-control study, including 28 PCFD feet and 28 controls matched for age, sex and Body Mass Index. Two-dimensional measurements included: axial and sagittal talus-first metatarsal angles (TM1A and TM1S), talonavicular coverage angle (TNCA), forefoot arch angle (FFAA), middle facet incongruence angle (MF°) and uncoverage percentage (MF%). The 3D Foot Ankle Offset (FAO) was obtained using dedicated semi-automatic software. Intra and interobserver reliabilities were assessed. Receiver Operating Characteristic (ROC) curves were calculated to determine diagnostic accuracy (Area Under the Curve (AUC)), sensitivity and specificity.
RESULTS: In PCFD, mean MF% and MF° were respectively 47.2% ± 15.4 and 13.3° ± 5.3 compared with 13.5% ± 8.7 and 5.6° ± 2.9 in controls (p < 0.001). The FAO was 8.1% ± 3.8 in PCFD and 1.4% ± 1.7 in controls (p < 0.001). AUCs were 0.99 (95%CI, 0.98-1) for MF%, 0.96 (95%CI, 0.9-1) for FAO, 0.90 (95%CI, 0.81-0.98) for MF°. For MF%, a threshold value equal or greater than 28.7% had a sensitivity of 100% and specificity of 92.8%. Conversely, a FAO value equal or greater than 4.6% had a specificity of 100% and a sensitivity of 89.2%. All other 2D measurements were significantly different in PCFD and controls (p < 0.001).
CONCLUSIONS: MF% and FAO were both accurate measurements for PCFD. MF% demonstrated slightly better specificity. FAO better sensitivity. A combination of threshold values of 28.7% for MF% and 4.6% for FAO yielded 100% sensitivity and specificity.