Zhang Fei, Xu Lin, Zhang Baoxiang, Song Shoulong, Sheng Xianhao, Xiong Wentao, Wang Ziran, Liao Weixiong, Zhang Qiang
Chinese PLA Medical School, Beijing, 100853, P. R. China.
Department of Orthopedic Surgery, Chinese PLA General Hospital, Beijing, 100853, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 May 15;37(5):551-555. doi: 10.7507/1002-1892.202301050.
To investigate the feasibility of MRI three-dimensional (3D) reconstruction model in quantifying glenoid bone defect by comparing with CT 3D reconstruction model measurement.
Forty patients with shoulder anterior dislocation who met the selection criteria between December 2021 and December 2022 were admitted as study participants. There were 34 males and 6 females with an average age of 24.8 years (range, 19-32 years). The injury caused by sports injury in 29 cases and collision injury in 6 cases, and 5 cases had no obvious inducement. The time from injury to admission ranged from 4 to 72 months (mean, 28.5 months). CT and MRI were performed on the patients' shoulder joints, and a semi-automatic segmentation of the images was done with 3D slicer software to construct a glenoid model. The length of the glenoid bone defect was measured on the models by 2 physicians. The intra-group correlation coefficient ( ) was used to evaluate the consistency between the 2 physicians, and Bland-Altman plots were constructed to evaluate the consistency between the 2 methods.
The length of the glenoid bone defects measured on MRI 3D reconstruction model was (3.83±1.36) mm/4.00 (0.58, 6.13) mm for physician 1 and (3.91±1.20) mm/3.86 (1.39, 5.96) mm for physician 2. The length of the glenoid bone defects measured on CT 3D reconstruction model was (3.81±1.38) mm/3.80 (0.60, 6.02) mm for physician 1 and (3.99±1.19) mm/4.00 (1.68, 6.38) mm for physician 2. and Bland-Altman plot analysis showed good consistency. The between the 2 physicians based on MRI and CT 3D reconstruction model measurements were 0.73 [95% (0.54, 0.85)] and 0.80 [95% (0.65, 0.89)], respectively. The 95% of the difference between the two measurements of physicians 1 and 2 were (-0.46, 0.49) and (-0.68, 0.53), respectively.
The measurement of glenoid bone defect based on MRI 3D reconstruction model is consistent with that based on CT 3D reconstruction model. MRI can be used instead of CT to measure glenoid bone defects in clinic, and the soft tissue of shoulder joint can be observed comprehensively while reducing radiation.
通过与CT三维（3D）重建模型测量结果进行比较，探讨MRI三维（3D）重建模型在量化肩胛盂骨缺损中的可行性。
选取2021年12月至2022年12月期间符合入选标准的40例肩关节前脱位患者作为研究对象。其中男性34例，女性6例，平均年龄24.8岁（范围19 - 32岁）。运动损伤所致29例，碰撞伤6例，5例无明显诱因。受伤至入院时间为4至72个月（平均28.5个月）。对患者肩关节行CT及MRI检查，采用3D Slicer软件对图像进行半自动分割以构建肩胛盂模型。由2名医师在模型上测量肩胛盂骨缺损长度。采用组内相关系数（ ）评估2名医师之间的一致性，并绘制Bland - Altman图评估两种方法之间的一致性。
医师1在MRI 3D重建模型上测量的肩胛盂骨缺损长度为（3.83±1.36）mm/4.00（0.58，6.13）mm，医师2测量结果为（3.91±1.20）mm/3.86（1.39，5.96）mm。医师1在CT 3D重建模型上测量的肩胛盂骨缺损长度为（3.81±1.38）mm/3.80（0.60，6.02）mm，医师2测量结果为（3.99±1.19）mm/4.00（1.68，6.38）mm。 及Bland - Altman图分析显示一致性良好。基于MRI和CT 3D重建模型测量，2名医师之间的 分别为0.73 [95% （0.54，0.85）]和0.80 [95% （0.65，0.89）]。医师1和医师2两次测量差值的95% 分别为（-0.46，0.49）和（-0.68，0.53）。
基于MRI 3D重建模型测量肩胛盂骨缺损与基于CT 3D重建模型测量结果一致。临床上MRI可替代CT测量肩胛盂骨缺损，在减少辐射的同时能全面观察肩关节软组织情况。
