Renna Maxwell S, Simpson Ashley I
Trauma & Orthopaedics, Guy's and St Thomas' Hospital, London, United Kingdom.
Peripheral Nerve Injury Unit, Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
Clin Shoulder Elb. 2025 Jul 31;28(3):281-8. doi: 10.5397/cise.2025.00318.
Accurate measurement of glenoid version is essential for optimal implant positioning in shoulder arthroplasty. This study compared the accuracy and reliability of unformatted two-dimensional computed tomography (2D-CT), formatted 2D-CT, and three-dimensional CT (3D-CT) reconstructions in measuring glenoid version.
Shoulder CT scans for arthroplasty were analyzed retrospectively. Glenoid version was measured at the estimated glenoid midpoint using unformatted and formatted 2D-CT in the scapular plane. Measurements from 3D-CT reconstructions using the Corrected Friedman Method were used as the control. Inter- and intra-observer reliability was calculated as well as minimally detectable difference.
Sixty-five CT scans were analyzed (mean age, 61.7 years). Mean glenoid version was -3.48° (standard deviation [SD], 8.7°) on unformatted 2D-CT, -3.27° (SD, 8.15°) on formatted 2D-CT, and -4.25° (SD, 7.92°) on 3D-CT. Although no significant difference in mean values was observed (analysis of variance, P=0.245), formatted 2D-CT measurements were within 6° of 3D-CT in 95.4% of cases versus 83.1% for unformatted 2D-CT (P=0.023). Directional error occurred in 27.7% of unformatted scans and 16.9% of formatted scans. Inter-observer reliability was highest for 3D-CT (intraclass correlation coefficient [ICC]=0.83; 95% CI, 0.74-0.89), and intra-observer agreement was strongest for 3D-CT (ICC=0.91; 95% CI, 0.86-0.94), followed by formatted 2D-CT (ICC=0.83; 95% CI, 0.73-0.89) and unformatted 2D-CT (ICC=0.77; 95% CI, 0.65-0.85).
3D-CT reconstructions are widely considered the most accurate and reproducible method for glenoid version assessment, supported by multiple comparative imaging studies. Formatted 2D-CT provides a reliable alternative when 3D-CT is unavailable, significantly outperforming unformatted 2D-CT in both agreement with the 3D reference and intra- and inter-observer reliability. Level of evidence: IV.
准确测量肩胛盂版本对于肩关节置换术中最佳植入物定位至关重要。本研究比较了未格式化二维计算机断层扫描（2D-CT）、格式化2D-CT和三维CT（3D-CT）重建在测量肩胛盂版本方面的准确性和可靠性。
对用于关节置换术的肩部CT扫描进行回顾性分析。在肩胛平面中使用未格式化和格式化的2D-CT在估计的肩胛盂中点测量肩胛盂版本。使用校正弗里德曼方法从3D-CT重建中获得的测量结果用作对照。计算观察者间和观察者内的可靠性以及最小可检测差异。
分析了65例CT扫描（平均年龄61.7岁）。未格式化2D-CT上的平均肩胛盂版本为-3.48°（标准差[SD]，8.7°），格式化2D-CT上为-3.27°（SD，8.15°），3D-CT上为-4.25°（SD，7.92°）。虽然平均值没有显著差异（方差分析，P=0.245），但在95.4%的病例中，格式化2D-CT测量值与3D-CT相差在6°以内，未格式化2D-CT为83.1%（P=0.023）。27.7%的未格式化扫描和16.9%的格式化扫描出现方向误差。观察者间可靠性在3D-CT中最高（组内相关系数[ICC]=0.83；95%CI，0.74-0.89），观察者内一致性在3D-CT中最强（ICC=0.91；95%CI，0.86-0.94），其次是格式化2D-CT（ICC=0.83；95%CI，0.73-0.89）和未格式化2D-CT（ICC=0.77；95%CI，0.65-
