Three-dimensional ultrasound imaging of coronal curvature and vertebral rotation changes from supine to standing in patients with adolescent idiopathic scoliosis

Abstract

Objective To investigate the gravitational effect on coronal curvature and vertebral rotation using 3-D ultrasound in patients with adolescent idiopathic scoliosis (AIS). Methods Sixteen female patients with AIS were recruited and examined using a 3-D ultrasound unit incorporated with SonixGPS system (Ultrasonix Medical Corporation, Canada). Ultrasound scanning was performed continuously along the coronal plane from C7 to S1, with a standing and a supine position, respectively. Coronal curvature and vertebral rotation were measured using the center of laminae (COL) method. Multivariate linear regression models were established to determine factors associated with changes of lateral curvature and vertebral rotation in different posture positions. The correlations of measurements between standing and supine were tested using Pearson correlation analyses. Results Changes of coronal curvature and vertebral rotation from a supine to a standing posture were within 1.9°-11.7° and 0.0°-5.9°, respectively. The changes increased with the severity of AIS. The 3-D ultrasound measurements of lateral curvature and vertebral rotation were highly correlated. Conclusion 3-D ultrasound can reveal changes of coronal curvature and vertebral rotation from a supine to a standing posture in patients with AIS, which increase with the severity of AIS. Further studies in large samples are warranted. 目的: 在站立位和仰卧位下，采用三维超声成像技术探索青少年特发性脊柱侧凸 (adolescent idiopathic scoliosis, AIS) 患者侧凸与旋转角度的变化规律。 方法: 2位测评者采用SonixTABLET三维超声成像系统，对16例AIS女性患者〔平均 (14.8 ± 1.7)岁〕进行站立位和仰卧位下扫描。AIS患者侧凸与旋转角度均采用椎板中心法(center of laminae, COL)进行测量。比较三维超声成像在站立位和仰卧位下测量结果的变化。采用多元线性回归法分析两种体位下三维超声测量结果变化的相关因素；应用Pearson相关分析评价两种体位下测量结果之间的相关性。 结果: 三维超声成像在站立位和仰卧位下测量脊柱侧凸角度的变化范围为1.9°~11.7°，顶锥旋转角度的变化范围为0.0°~5.9°。两种体位下脊柱侧凸角度的变化与侧凸角度的大小及侧凸上端椎选择的差异有关；而顶锥旋转角度的变化与旋转角度本身的大小有关；且两种体位之间高度相关 (r>0.9)。 结论: 三维超声成像能够显示出AIS患者在站立位和仰卧位下脊柱侧凸与旋转角度的变化规律，随着脊柱侧凸角度的增加，两种体位下侧凸角度的变化幅度均增加，椎骨旋转角度的变化情况不同。