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Glenoid Bone Loss Measurement in Recurrent Shoulder Dislocation: Assessment of Measurement Agreement Between CT and MRI.

Friedman LG, Ulloa SA, Braun DT, Saad HA, Jones MH, Miniaci AA - Orthop J Sports Med (2014)

Bottom Line: Vertical measurements were taken from the superior glenoid tubercle and directed inferiorly along the glenoid; horizontal measurements were taken across the widest part of the face of the glenoid and were perpendicular within one-half of 1° to the vertical measurement.There is moderate correlation between MRI and CT scans when measuring the glenoid, indicating that taking the length-to-height ratio measurements across the glenoid is a promising way to estimate the glenoid defect.At present, a complete workup of a patient with shoulder instability includes both a CT scan and an MRI.

View Article: PubMed Central - PubMed

Affiliation: Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.

ABSTRACT

Background: Shoulder instability can cause both soft tissue injury and bone defects, requiring both computed tomography (CT) and magnetic resonance imaging (MRI) for a thorough workup, which results in high patient costs and radiation exposure. Prior studies in cadaveric and nonclinical models have shown promise in assessing preoperative bone loss utilizing MRI.

Purpose: To evaluate the utility of MRI in detecting and evaluating glenoid bone defects in a clinical setting. The aim was to establish whether similar information could be determined by utilizing MRI and CT in a population with recurrent instability.

Study design: Cohort study (diagnosis); Level of evidence, 2.

Methods: CT and MRI scans of 22 shoulders were read by 4 orthopaedic surgeons. The CT images were obtained on a 2-dimensional CT scanner. Vertical measurements were taken from the superior glenoid tubercle and directed inferiorly along the glenoid; horizontal measurements were taken across the widest part of the face of the glenoid and were perpendicular within one-half of 1° to the vertical measurement. The same protocol was followed for MRI measurements. An intraclass correlation coefficient (ICC) was calculated.

Results: There was a moderate amount of agreement between examiners for the height measurements on MRI (ICC, 0.53) and a substantial agreement for the CT images (ICC, 0.64). The width measurements for MRI had a moderate amount of agreement (ICC, 0.41), while the CT images had a fair agreement (ICC, 0.39). The height measurements between the measurements of MRI and CT images had an overall ICC of 0.43, while the width measurements had an overall ICC of 0.41, both of which were considered a moderate amount of agreement.

Conclusion: There is moderate correlation between MRI and CT scans when measuring the glenoid, indicating that taking the length-to-height ratio measurements across the glenoid is a promising way to estimate the glenoid defect. At present, a complete workup of a patient with shoulder instability includes both a CT scan and an MRI. Future research that establishes precisely how MRI misestimates CT measurements of the glenoid can perhaps obviate the need for 2 scans.

No MeSH data available.


Related in: MedlinePlus

Agreement of width measurements between MRI and CT.
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fig7-2325967114549541: Agreement of width measurements between MRI and CT.

Mentions: Likewise, the MRI width measurements for the glenoid were moderately reliable for predicting the CT measurements and vice versa. The ICCs between the CT and MRI measurements for height were 0.30, 0.36, 0.28, and 0.54 for the 4 readers, yielding an overall intraclass correlation for height of 0.43, which represented a moderate amount of agreement. An average MRI width for the glenoid as measured by MRI was 23 mm. A graphical representation of the height measurements from CT and MRI measurements had slopes that were significantly different than 1 (P < .001) (Figure 7). Just as for the height, the graph indicates the large measurements made by MRI were, on average, too large, and the small measurements made by MRI were too small compared with the CT measurements (Table 2).


Glenoid Bone Loss Measurement in Recurrent Shoulder Dislocation: Assessment of Measurement Agreement Between CT and MRI.

Friedman LG, Ulloa SA, Braun DT, Saad HA, Jones MH, Miniaci AA - Orthop J Sports Med (2014)

Agreement of width measurements between MRI and CT.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4555629&req=5

fig7-2325967114549541: Agreement of width measurements between MRI and CT.
Mentions: Likewise, the MRI width measurements for the glenoid were moderately reliable for predicting the CT measurements and vice versa. The ICCs between the CT and MRI measurements for height were 0.30, 0.36, 0.28, and 0.54 for the 4 readers, yielding an overall intraclass correlation for height of 0.43, which represented a moderate amount of agreement. An average MRI width for the glenoid as measured by MRI was 23 mm. A graphical representation of the height measurements from CT and MRI measurements had slopes that were significantly different than 1 (P < .001) (Figure 7). Just as for the height, the graph indicates the large measurements made by MRI were, on average, too large, and the small measurements made by MRI were too small compared with the CT measurements (Table 2).

Bottom Line: Vertical measurements were taken from the superior glenoid tubercle and directed inferiorly along the glenoid; horizontal measurements were taken across the widest part of the face of the glenoid and were perpendicular within one-half of 1° to the vertical measurement.There is moderate correlation between MRI and CT scans when measuring the glenoid, indicating that taking the length-to-height ratio measurements across the glenoid is a promising way to estimate the glenoid defect.At present, a complete workup of a patient with shoulder instability includes both a CT scan and an MRI.

View Article: PubMed Central - PubMed

Affiliation: Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.

ABSTRACT

Background: Shoulder instability can cause both soft tissue injury and bone defects, requiring both computed tomography (CT) and magnetic resonance imaging (MRI) for a thorough workup, which results in high patient costs and radiation exposure. Prior studies in cadaveric and nonclinical models have shown promise in assessing preoperative bone loss utilizing MRI.

Purpose: To evaluate the utility of MRI in detecting and evaluating glenoid bone defects in a clinical setting. The aim was to establish whether similar information could be determined by utilizing MRI and CT in a population with recurrent instability.

Study design: Cohort study (diagnosis); Level of evidence, 2.

Methods: CT and MRI scans of 22 shoulders were read by 4 orthopaedic surgeons. The CT images were obtained on a 2-dimensional CT scanner. Vertical measurements were taken from the superior glenoid tubercle and directed inferiorly along the glenoid; horizontal measurements were taken across the widest part of the face of the glenoid and were perpendicular within one-half of 1° to the vertical measurement. The same protocol was followed for MRI measurements. An intraclass correlation coefficient (ICC) was calculated.

Results: There was a moderate amount of agreement between examiners for the height measurements on MRI (ICC, 0.53) and a substantial agreement for the CT images (ICC, 0.64). The width measurements for MRI had a moderate amount of agreement (ICC, 0.41), while the CT images had a fair agreement (ICC, 0.39). The height measurements between the measurements of MRI and CT images had an overall ICC of 0.43, while the width measurements had an overall ICC of 0.41, both of which were considered a moderate amount of agreement.

Conclusion: There is moderate correlation between MRI and CT scans when measuring the glenoid, indicating that taking the length-to-height ratio measurements across the glenoid is a promising way to estimate the glenoid defect. At present, a complete workup of a patient with shoulder instability includes both a CT scan and an MRI. Future research that establishes precisely how MRI misestimates CT measurements of the glenoid can perhaps obviate the need for 2 scans.

No MeSH data available.


Related in: MedlinePlus