Kim Jung-Han, Min Young-Kyoung
Department of Orthopedic Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
Clin Shoulder Elb. 2018 Dec 1;21(4):186-191. doi: 10.5397/cise.2018.21.4.186. eCollection 2018 Dec.
To determine the normal range of humeral head positioning on magnetic resonance imaging (MRI).
We selected normal subjects (64 patients; group A) to study the normal range of humeral head positioning on the glenoid by MRI measurements. To compare the MRI measurement method with the computed tomography (CT), we selected group B (70 patients) who underwent both MRI and CT. We measured the humeral-scapular alignment (HSA) and the humeral-glenoid alignment (HGA).
The HSA in the control group was 1.47 ± 1.05 mm, and the HGA with and without reconstruction were 1.15 ± 0.65 mm and 1.03 ± 0.59 mm, respectively, on MRI. In the test group, HSA was 2.67 ± 1.47 mm and HGA with and without reconstruction was 1.58 ± 1.16 mm and 1.49 ± 1.08 mm, on MRI. On CT, the HSA was 1.72 ± 1.01 mm, and HGA with and without reconstruction were 1.54 ± 0.96 mm and 1.59 ± 0.93 mm, respectively. HSA was significantly different according to image modality (=0.0006), but HGA was not significantly different regardless of reconstruction (=0.8836 and 0.9234).
Although additional CT scans can be taken to measure decentering in patients with rotator cuff tears, reliable measurements can be obtained with MRI alone. When using MRI, it is better to use HGA, which is a more reliable measurement value based on the comparison with CT measurement (study design: Study of Diagnostic Test; Level of evidence II).
确定磁共振成像(MRI)上肱骨头定位的正常范围。
我们选择正常受试者(64例患者;A组),通过MRI测量研究肱骨头在肩胛盂上的正常定位范围。为了将MRI测量方法与计算机断层扫描(CT)进行比较,我们选择了同时接受MRI和CT检查的B组(70例患者)。我们测量了肱骨-肩胛对齐(HSA)和肱骨-肩胛盂对齐(HGA)。
在MRI上,对照组的HSA为1.47±1.05mm,重建前后的HGA分别为1.15±0.65mm和1.03±0.59mm。在测试组中,MRI上的HSA为2.67±1.47mm,重建前后的HGA分别为1.58±1.16mm和1.49±1.08mm。在CT上,HSA为1.72±1.01mm,重建前后的HGA分别为1.54±0.96mm和1.59±0.93mm。根据成像方式,HSA有显著差异(=0.0006),但无论是否重建,HGA均无显著差异(=0.8836和0.9234)。
虽然对于肩袖撕裂患者可以额外进行CT扫描以测量偏心情况,但仅通过MRI就能获得可靠的测量结果。使用MRI时,最好使用HGA,基于与CT测量的比较,HGA是更可靠的测量值(研究设计:诊断试验研究;证据级别:II级)。