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肩盂上倾斜角与肩袖撕裂。

Superior glenoid inclination and rotator cuff tears.

机构信息

Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA.

Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA.

出版信息

J Shoulder Elbow Surg. 2018 Aug;27(8):1444-1450. doi: 10.1016/j.jse.2018.02.043. Epub 2018 Mar 23.

Abstract

BACKGROUND

The objectives of this study were to determine whether glenoid inclination (1) could be measured accurately on magnetic resonance imaging (MRI) using computed tomography (CT) as a gold standard, (2) could be measured reliably on MRI, and (3) whether it differed between patients with rotator cuff tears and age-matched controls without evidence of rotator cuff tears or glenohumeral osteoarthritis.

METHODS

In this comparative retrospective radiographic study, we measured glenoid inclination on T1 coronal MRI corrected into the plane of the scapula. We determined accuracy by comparison with CT and inter-rater reliability. We compared glenoid inclination between patients with full-thickness rotator cuff tears and patients aged >50 years without evidence of a rotator cuff tear or glenohumeral arthritis. An a priori power analysis determined adequate power to detect a 2° difference in glenoid inclination.

RESULTS

(1) In a validation cohort of 37 patients with MRI and CT, the intraclass correlation coefficient was 0.877, with a mean difference of 0° (95% confidence interval, -1° to 1°). (2) For MRI inclination, the inter-rater intraclass correlation coefficient was 0.911. (3) Superior glenoid inclination was 2° higher (range, 1°-4°, P < .001) in the rotator cuff tear group of 192 patients than in the control cohort of 107 patients.

CONCLUSIONS

Glenoid inclination can be accurately and reliably measured on MRI. Although superior glenoid inclination is statistically greater in those with rotator cuff tears than in patients of similar age without rotator cuff tears or glenohumeral arthritis, the difference is likely below clinical significance.

摘要

背景

本研究旨在确定在磁共振成像(MRI)上使用计算机断层扫描(CT)作为金标准时,(1)能否准确测量肩盂倾斜度,(2)能否在 MRI 上可靠地测量肩盂倾斜度,以及(3)肩袖撕裂患者与年龄匹配的无肩袖撕裂或肩峰下关节炎证据的对照组之间是否存在差异。

方法

在这项比较性回顾性放射学研究中,我们使用 T1 冠状位 MRI 测量了肩胛骨关节盂倾斜度,并校正为肩胛骨关节盂平面。我们通过与 CT 比较来确定准确性,并通过组内相关系数评估组内可靠性。我们比较了肩袖全层撕裂患者和年龄>50 岁且无肩袖撕裂或肩峰下关节炎证据的患者之间的肩盂倾斜度。基于先验的功效分析,确定了检测肩盂倾斜度 2°差异的足够功效。

结果

(1)在包含 37 例 MRI 和 CT 的验证队列中,组内相关系数为 0.877,平均差值为 0°(95%置信区间,-1°至 1°)。(2)对于 MRI 倾斜度,两位评估者的组内相关系数为 0.911。(3)在 192 例肩袖撕裂患者的组中,肩盂上倾斜度比 107 例对照组高 2°(范围,1°-4°,P<0.001)。

结论

在 MRI 上可以准确、可靠地测量肩盂倾斜度。尽管肩袖撕裂患者的肩盂上倾斜度在统计学上高于无肩袖撕裂或肩峰下关节炎的年龄匹配患者,但这种差异可能低于临床意义。

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