Gauci Marc-Olivier, Jacquot Adrien, Boux de Casson François, Deransart Pierric, Letissier Hoël, Berhouet Julien
Institut Universitaire Locomoteur et du Sport, CHU de Nice, 06000 Nice, France.
Unité de Recherche Clinique Côte d'Azur (UR2CA), Université Côte d'Azur, 06000 Nice, France.
J Clin Med. 2022 Oct 13;11(20):6050. doi: 10.3390/jcm11206050.
The aim of this study was to evaluate the variation in measured glenoid inclination measurements between each of the most used methods for measuring the scapular transverse axis with computed tomography (CT) scans, and to investigate the underlying causes that explain the differences.
The glenoid center, trigonum and supraspinatus fossa were identified manually by four expert shoulder surgeons on 82 scapulae CT-scans. The transverse axis was generated either from the identified landmarks (Glenoid-Trigonum line (GT-line), Best-Fit Line Fossa (BFLF)) or by an automatic software (-axis). An assessment of the interobserver reliability was performed. We compared the measured glenoid inclination when modifying the transverse axis to assess its impact.
Glenoid inclination remained stable between 6.3 and 8.5°. The variations occurred significantly when changing the method that determined the transverse axis with a mean biase from -1.7 (BFLF vs. -axis) to 0.6 (BFLF vs. GT-line). The -axis method showed higher stability to the inclination variation ( = 0.030). 9% of cases presented more than 5° of discrepancies between the methods. The manual methods presented a lower ICC (BFLF = 0.96, GT-line = 0.87) with the widest dispersion.
Methods that determine the scapular transverse axis could have a critical impact on the measurement of the glenoid inclination. Despite an overall good concordance, around 10% of cases may provide high discrepancies (≥5°) between the methods with a possible impact on surgeon clinical choice. Trigonum should be used with caution as its anatomy is highly variable and more than two single points provide a better interrater concordance. The -axis is the most stable referential for the glenoid inclination.
本研究的目的是评估使用计算机断层扫描（CT）扫描测量肩胛横轴的最常用方法之间，所测得的关节盂倾斜度测量值的差异，并探究解释这些差异的潜在原因。
四名肩部外科专家在82例肩胛骨CT扫描图像上手动识别关节盂中心、三角肌和冈上肌窝。横轴可根据识别出的标志点生成（关节盂-三角肌线（GT线）、最佳拟合线窝（BFLF）），也可通过自动软件生成（-轴）。进行了观察者间可靠性评估。我们在改变横轴时比较所测得的关节盂倾斜度，以评估其影响。
关节盂倾斜度在6.3°至8.5°之间保持稳定。当改变确定横轴的方法时，差异显著，平均偏差从-1.7（BFLF与-轴相比）到0.6（BFLF与GT线相比）。-轴方法对倾斜度变化显示出更高的稳定性（=0.030）。9%的病例在不同方法之间存在超过5°的差异。手动方法的组内相关系数较低（BFLF = 0.96，GT线 = 0.87），离散度最大。
确定肩胛横轴的方法可能对关节盂倾斜度的测量产生关键影响。尽管总体一致性良好，但约10%的病例在不同方法之间可能存在较大差异（≥5°），这可能会影响外科医生的临床选择。三角肌的使用应谨慎，因为其解剖结构高度可变，使用两个以上单点可提供更好的观察者间一致性。-轴是关节盂倾斜度最稳定的参考标准。
