Department of Orthopaedics and Rehabilitation, Penn State College of Medicine Milton S. Hershey Medical Center, Hershey, PA, USA.
Department of Orthopaedics and Rehabilitation, Penn State College of Medicine Milton S. Hershey Medical Center, Hershey, PA, USA.
J Shoulder Elbow Surg. 2018 Jul;27(7):1297-1305. doi: 10.1016/j.jse.2017.11.020. Epub 2018 Jan 10.
Conventional computed tomography (CT) is not accurate for glenoid version measurement. This study sought to examine the feasibility of an interdepartmental protocol implemented between orthopedic surgery and radiology departments for acquisition of anatomic axial CT images and to validate the glenoid version measured through such a protocol.
Data of 30 conventional CT scans of 10 normal and 20 osteoarthritic glenoids were transferred to clinical 3-dimensional imaging software by a radiology technician trained for the study. The technician independently reoriented the scapulae to generate anatomic CT images. A separate team of orthopedic researchers used laboratory-based 3-dimensional reconstruction software (Mimics; Materialise, Leuven, Belgium) to generate anatomic axial images. Three independent examiners measured glenoid version on the conventional CT, reoriented anatomic CT, and Mimics images at the superior, middle, and inferior levels. Data were analyzed using the Mimics data as the "gold standard."
Reoriented anatomic CT images generated by the technician resulted in almost identical version measurements to the Mimics images in both normal and arthritic glenoids. The conventional CT images had poor agreement with the Mimics images in normal glenoids but had good agreement in arthritic glenoids. Both normal and arthritic glenoids had increased retroversion superiorly (P < .05), and this phenomenon was significantly exaggerated on the conventional CT images (P < .05).
This study demonstrated that an interdepartmental protocol can produce reoriented anatomic axial CT images on which true glenoid version can be accurately measured. Such an institutional protocol would help surgeons accurately evaluate glenoid version preoperatively with reduced workload and expense.
传统的计算机断层扫描(CT)对肩胛盂版本的测量并不准确。本研究旨在探讨在骨科和放射科之间实施的部门间协议获取解剖轴位 CT 图像的可行性,并验证通过该协议测量的肩胛盂版本。
将 10 个正常和 20 个骨关节炎肩胛盂的 30 个常规 CT 扫描数据由经过培训的放射科技术员转移到临床三维成像软件中。技术员独立重新定位肩胛骨以生成解剖 CT 图像。一组独立的骨科研究人员使用基于实验室的三维重建软件(Mimics;Materialise,比利时鲁汶)生成解剖轴位图像。三位独立的检查者在常规 CT、重新定向的解剖 CT 和 Mimics 图像上测量肩胛盂的版本,在上方、中间和下方三个水平进行测量。使用 Mimics 数据作为“金标准”进行数据分析。
技术员生成的重新定向解剖 CT 图像在正常和关节炎肩胛盂中几乎与 Mimics 图像的版本测量结果完全一致。常规 CT 图像在正常肩胛盂中与 Mimics 图像的一致性较差,但在关节炎肩胛盂中一致性较好。正常和关节炎肩胛盂的上部均有较大的后旋(P<.05),而这种现象在常规 CT 图像上更为明显(P<.05)。
本研究表明,部门间协议可以生成可准确测量真实肩胛盂版本的重新定向解剖轴位 CT 图像。这种机构协议将有助于外科医生在术前更准确地评估肩胛盂的版本,减少工作量和费用。