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除了 Hill-Sachs 间隙外,CT 和 MRI 在 HSL 测量的诊断价值方面没有显著差异,无论测量技术如何。

With the exception of the Hill-Sachs interval, CT and MRI show no significant differences in the diagnostic value of the HSL measurement regardless of the measurement technique.

机构信息

Department for Orthopaedic Surgery, RKU, University of Ulm, Ulm, Germany.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2021 Dec;29(12):3981-3988. doi: 10.1007/s00167-021-06695-5. Epub 2021 Aug 16.

DOI:10.1007/s00167-021-06695-5
PMID:34398261
Abstract

PURPOSE

The aim of the current study was to compare the diagnostic precision and reliability of different methods in measuring Hill-Sachs lesions (HSLs) using MRI and CT.

METHODS

A total of 80 consecutive patients with a history of anterior shoulder instability were retrospectively included. The preoperative CT and MRI scans of the affected shoulders were analysed. To investigate the ability of the Franceschi grading, Calandra classification, Richards, Hall, and Rowe grading scale, Flatow percentage and "glenoid track" assessment according to Di Giacomo et al. to quantify the extent of humeral bone loss, the results of each measurement method obtained with MRI were compared with those achieved with CT. In addition, the intra- and inter-rater reliabilities of each measurement method using CT and MRI were calculated and compared.

RESULTS

A significant difference was found between CT and MRI in the determination of the Hill-Sachs interval (HSI) (p = 0.016), but not between the results of any of the other measurement techniques. With the exceptions of the Franceschi grade and Calandra classification, all measurement methods showed good or excellent intra- and inter-rater reliabilities for both MRI and CT.

CONCLUSIONS

While the determination of the HSI with MRI was more accurate, all other analysed techniques for measuring the amount of humeral bone loss showed similar diagnostic precision. With regard to the intra- and inter-rater reliabilities, all measurement techniques analysed, with the exception of the Franceschi and Calandra classifications, provided good to very good reliabilities with both CT and MRI.

LEVEL OF EVIDENCE

III.

摘要

目的

本研究旨在比较 MRI 和 CT 测量 Hill-Sachs 损伤(HSL)的不同方法的诊断精度和可靠性。

方法

回顾性纳入 80 例有前肩不稳定病史的连续患者。分析了受累肩部的术前 CT 和 MRI 扫描。为了研究 Franceschi 分级、Calandra 分类、Richards、Hall 和 Rowe 分级、Flatow 百分比和 Di Giacomo 等人的“关节盂轨迹”评估定量肱骨头骨丢失程度的能力,将每种 MRI 测量方法的结果与 CT 结果进行比较。此外,还计算并比较了每种 CT 和 MRI 测量方法的组内和组间可靠性。

结果

CT 和 MRI 在确定 Hill-Sachs 间隔(HSI)方面存在显著差异(p = 0.016),但其他任何测量技术的结果均无差异。除了 Franceschi 分级和 Calandra 分类外,所有测量方法在 MRI 和 CT 上的组内和组间可靠性均良好或优秀。

结论

虽然 MRI 对 HSI 的测定更准确,但其他用于测量肱骨头骨丢失量的分析技术的诊断精度相似。关于组内和组间可靠性,除了 Franceschi 和 Calandra 分类外,所有分析的测量技术在 CT 和 MRI 上均提供了良好到非常好的可靠性。

证据水平

III。

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