MRI三维重建评估肩关节脱位关节盂骨缺损的应用研究  

Study on the evaluation of glenoid bone defects by MRI three-dimensional reconstruction

作　　者：张飞 许霖[3] 张宝祥 宋首龙 盛显浩 熊文韬 王子然 廖伟雄 张强[2] 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;Department of Radiology,Chinese PLA General Hospital,Beijing,100853,P.R.China;Department of Orthopedic Surgery,Hainan Hospital of Chinese PLA General Hospital,Sanya Hainan,572013,P.R.China;Department of Orthopedic Surgery,the 903rd Hospital of Chinese PLA,Hangzhou Zhejiang,310013,P.R.China;Department of Emergency,Chinese PLA General Hospital,Beijing,100853,P.R.China)

机构地区：[1]中国人民解放军医学院,北京100853 [2]中国人民解放军总医院骨科医学部,北京100853 [3]中国人民解放军总医院放射科,北京100853 [4]中国人民解放军总医院海南医院骨科,海南三亚572013 [5]中国人民解放军第903医院骨科,杭州310013 [6]中国人民解放军总医院急诊科,北京100853

出　　处：《中国修复重建外科杂志》2023年第5期551-555,共5页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：首都卫生发展科研专项(2022-2-5051);解放军总医院转化项目(ZH19008)。

摘　　要：目的通过与CT三维重建关节盂模型测量比较,探讨基于MRI三维重建关节盂模型测量肩关节脱位关节盂骨缺损的可行性。方法以2021年12月—2022年12月收治且符合选择标准的40例肩关节前脱位患者作为研究对象。其中男34例,女6例;年龄19~32岁,平均24.8岁。运动伤29例、撞伤6例,无明显诱因5例。受伤至入院时间4~72个月,平均28.5个月。对患者肩关节行CT和MRI检查,采用3D slicer软件对图像进行阈值半自动分割,构建关节盂模型。由2名医生在模型上测量关节盂骨缺损长度。采用组内相关系数(ICC)评价2名医生测量一致性,构建Bland-Altman图评价2种方法测量一致性。结果关节盂骨缺损长度基于MRI三维重建模型测量,医生1为(3.83±1.36)mm、4.00(0.58,6.13)mm,医生2为(3.91±1.20)mm、3.86(1.39,5.96)mm;基于CT三维重建模型测量,医生1为(3.81±1.38)mm、3.80(0.60,6.02)mm,医生2为(3.99±1.19)mm、4.00(1.68,6.38)mm。ICC及Bland-Altman图分析均显示良好一致性。其中,2名医生间基于MRI、CT三维重建模型测量结果的ICC分别为0.73[95%CI(0.54,0.85)]、0.80[95%CI(0.65,0.89)]。医生1、2两项测量结果差值95%CI分别为(–0.46,0.49)、(–0.68,0.53)。结论基于MRI三维重建关节盂模型测量关节盂骨缺损与基于CT三维重建模型测量具有良好一致性。临床工作中可选择MRI替代CT测量关节盂骨缺损,在减少辐射的同时能全面观察肩关节软组织结构。Objective To investigate the feasibility of MRI three-dimensional(3D)reconstruction model in quantifying glenoid bone defect by comparing with CT 3D reconstruction model measurement.Methods 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 intragroup correlation coefficient(ICC)was used to evaluate the consistency between the 2 physicians,and Bland-Altman plots were constructed to evaluate the consistency between the 2 methods.Results 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.ICC and Bland-Altman plot analysis showed good consistency.The ICC between the 2 physicians based on MRI and CT 3D reconstruction model measurements were 0.73[95%CI(0.54,0.85)]and 0.80[95%CI(0.65,0.89)],respectively.The 95%CI of the difference between the two measurements of physicians 1 and 2 were(–0.46,0.49)and(–0.68,0.53),respectively.Conclusion 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 join

关 键 词：肩关节脱位 关节盂骨缺损 MRI三维重建 CT三维重建 

分 类 号：R445.2[医药卫生—影像医学与核医学] R684.7[医药卫生—诊断学]