Abstract
Objective
Computed tomography (CT) is the gold standard for evaluating glenoid bone loss in patients with glenohumeral dislocations. The aim of this study was to verify if magnetic resonance imaging (MRI) can quantify the area of bone loss without any significant difference from CT.
Materials and methods
Twenty-three patients, who had experienced one or more post-traumatic unilateral glenohumeral dislocations, underwent MRI and CT. MR and multiplanar reconstruction CT images were acquired in the sagittal plane: the glenoid area and the area of bone loss were calculated using the PICO method. Mean values, percentages, Cohen’s kappa coefficients and Bland-Altman plots were all used to confirm the working hypothesis.
Results
The mean glenoid surface area was 575.29 mm2 as measured by MRI, and 573.76 mm2 as measured by CT; the calculated mean glenoid bone loss was respectively 4.38% and 4.34%. The interobserver agreement was good (k>0.81), and the coefficient of variance was 5% of the mean value using both methods. The two series of measurements were within two standard deviations of each other.
Conclusions
MRI is a valid alternative to CT for measuring glenoid bone loss in patients with glenohumeral dislocation.
Riassunto
Obiettivo
La tomografia computerizzata (TC) è il gold standard nella valutazione del danno osseo glenoideo in pazienti con lussazione gleno-omerale. Lo scopo dello studio è verificare se la risonanza magnetica (RM) può quantificare l’area di danno osseo senza significative differenze rispetto alla TC.
Materiali e metodi
Ventitre pazienti con uno o più episodi di lussazione traumatica gleno-omerale unilaterale sono stati sottoposti a RM e TC. Sono state acquisite le ricostruzioni MPR in TC e le immagini RM sul piano sagittale: la misura dell’area della glena e la misura del danno osseo sono state effettuate utilizzando il metodo PICO. Medie, percentuali, test di concordanza K di Cohen e Bland-Altman test sono stati elaborati per confermare l’ipotesi di lavoro.
Risultati
La misura dell’area glenoidea risulta di 575,29 mm2 con RM e di 573,76 mm2 con TC e le rispettive misure del deficit glenoideo sono di 4,38% e 4,34%. La concordanza inter-osservatore in TC e RM è risultata buona con k>0,81, il coefficiente di varianza è <5% del valor medio sia in TC che RM. Le due serie di misurazioni sono comprese entro 2 deviazioni standard.
Conclusioni
La RM è una valida alternativa alla TC nella misurazione del danno osseo glenoideo in pazienti con dislocazioni gleno-omerali.
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Stecco, A., Guenzi, E., Cascone, T. et al. MRI can assess glenoid bone loss after shoulder luxation: inter- and intra-individual comparison with CT. Radiol med 118, 1335–1343 (2013). https://doi.org/10.1007/s11547-013-0927-x
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DOI: https://doi.org/10.1007/s11547-013-0927-x