Division of Trauma Surgery, University Hospital of Zurich, University of Zurich, Zürich, Switzerland.
Division of Trauma Surgery, University Hospital of Zurich, University of Zurich, Zürich, Switzerland.
J Shoulder Elbow Surg. 2018 Apr;27(4):659-666. doi: 10.1016/j.jse.2017.10.006. Epub 2018 Jan 9.
An increasing number of parameters measured on anteroposterior radiographs are used for the evaluation of the bony geometry of the scapula. Inhomogeneous acquisition of images is common because of the lack of standardization in radiographic positioning. Images with malrotation around the horizontal axis of the scapula are particularly frequent. We hypothesized that malrotated images would result in large variations in measured radiographic parameters and that image standardization using qualitative and semiquantitative "omometric" criteria would decrease these variations in measurements. "Omometry" is a newly introduced umbrella term that contains all standardized measurements on plain radiographs of the shoulder, analogous to the term "coxometry," which is widely used for the radiographic assessment of the osseous pelvis and hip.
In this experimental, cadaveric radiographic study, 7 dry-bone human scapula cadaveric specimens from anonymous donors were used to obtain 210 radiographs. We incrementally rotated (steps of 3°) every scapula around its horizontal and vertical axis, with a total range of 42° per each axis. Then, we measured 5 radiographic parameters on every image and observed their change with malrotation. Furthermore, we introduced 4 omometric criteria defining an appropriate (presence of ≥3 criteria) radiographic image to improve standardization of scapular image acquisition.
Overall, measured values remained stable within a narrow range of ±9° of malrotation. Beyond this range, values of all parameters significantly deviated (>±2°) from the initial value. Measurements on appropriate images were significantly less prone to deviation. Within the appropriate images, those with 4 criteria showed a higher specificity than those with 3 criteria.
There is significant variation in values of measured radiographic parameters on anteroposterior radiographs of the scapula with substantially malrotated images. With the use of the 4 newly introduced semiquantitative and qualitative omometric criteria, which define an appropriate image, reliability of the measured parameters can be significantly improved.
越来越多的参数在前后位 X 线片上进行测量，用于评估肩胛骨的骨骼几何形状。由于缺乏 X 线摄影定位的标准化，图像的不均匀采集很常见。肩胛骨水平轴周围旋转不良的图像尤其常见。我们假设旋转不良的图像会导致测量的 X 射线参数出现较大差异，并且使用定性和半定量的“量测”标准对图像进行标准化会减少这些测量值的变化。“量测”是一个新引入的术语，它包含了肩部平片上所有的标准化测量，类似于“骨盆测量”，这是一个广泛用于骨骼骨盆和髋关节 X 射线评估的术语。
在这项实验性的、尸体放射学研究中，使用 7 具来自匿名供体的干骨人肩胛骨尸体标本获得 210 张 X 线片。我们以 3°为步长，对每个肩胛骨的水平轴和垂直轴进行逐步旋转（每个轴旋转 42°）。然后，我们在每张 X 线片上测量 5 个 X 射线参数，并观察它们随旋转不良的变化。此外，我们引入了 4 个量测标准，定义了一个合适的（存在≥3 个标准）X 射线图像，以提高肩胛骨图像采集的标准化。
总体而言，在旋转不良的±9°范围内，测量值保持稳定。超出这个范围，所有参数的值都显著偏离（>±2°）初始值。在合适的图像上进行测量偏差较小。在合适的图像中，有 4 个标准的图像比有 3 个标准的图像具有更高的特异性。
肩胛骨前后位 X 线片中，旋转不良的图像测量值的变化显著。使用新引入的 4 个半定量和定性的量测标准，可以显著提高测量参数的可靠性，这些标准定义了一个合适的图像。
