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 intra-group 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 joint can be observed comprehensively while reducing radiation.
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。.
Keywords: CT three-dimensional reconstruction; MRI three-dimensional reconstruction; Shoulder dislocation; glenoid bone defect.