Reliability and Validity Study of Clinical Ultrasound Imaging on Lateral Curvature of Adolescent Idiopathic Scoliosis.
BACKGROUND
Non-ionizing radiation imaging assessment has been advocated for the patients with adolescent idiopathic scoliosis (AIS). As one of the radiation-free methods, ultrasound imaging has gained growing attention in scoliosis assessment over the past decade. The center of laminae (COL) method has been proposed to measure the spinal curvature in the coronal plane of ultrasound image. However, the reliability and validity of this ultrasound method have not been validated in the clinical setting.


OBJECTIVE
To evaluate the reliability and validity of clinical ultrasound imaging on lateral curvature measurements of AIS with their corresponding magnetic resonance imaging (MRI) measurements.


METHODS
Thirty curves (ranged 10.2°-68.2°) from sixteen patients with AIS were eligible for this study. The ultrasound scan was performed using a 3-D ultrasound unit within the same morning of MRI examination. Two researchers were involved in data collection of these two examinations. The COL method was used to measure the coronal curvature in ultrasound image, compared with the Cobb method in MRI. The intra- and inter-rater reliability of the COL method was evaluated by intra-class correlation coefficient (ICC). The validity of this method was analyzed by paired Student's t-test, Bland-Altman statistics and Pearson correlation coefficient. The level of significance was set as 0.05.


RESULTS
The COL method showed high intra- and inter-rater reliabilities (both with ICC (2, K) >0.9, p<0.05) to measure the coronal curvature. Compared with Cobb method, COL method showed no significant difference (p<0.05) when measuring coronal curvature. Furthermore, Bland-Altman method demonstrated an agreement between these two methods, and Pearson's correlation coefficient (r) was high (r>0.9, p<0.05).


CONCLUSIONS
The ultrasound imaging could provide a reliable and valid measurement of spinal curvature in the coronal plane using the COL method. Further research is needed to validate the proposed ultrasound measurement in larger clinical trial and to optimize the ultrasound scanning and measuring procedure.
Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China; Center of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China; Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China.
Q
Q
Wang
Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China.
M
M
Li
Department of Surgery, Glenrose Rehabilitation Research Centre, University of Alberta, Edmonton, Canada.
Edmond H M
EH
Lou
Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China.
M S
MS
Wong
D000293:Adolescent; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D015203:Reproducibility of Results; D012600:Scoliosis / Q000175:diagnosis / Q000000981:diagnostic imaging*