背景:这项研究的目的是评估Golding等人首次描述的肩关节距离(AHD)测量的观察者间可靠性。,临界肩角(CSA),肩峰指数与肾盂肱骨(GH)和肾盂肩峰(GA)距离,遵循Nyffeler等人的测量方法。,侧肩峰角(LAA),以及X线和MRI中根据Bigliani的肩峰形态和根据Maloney的肱骨头位置。此外,该研究评估了X射线测量结果与AHDMRI测量结果的相关性,CSA,GA,GH,AI,还有LAA.
方法:共187例患者于2016年9月至2023年5月接受肩关节X线和MRI检查。成像质量差的患者,关节病或根治性手术,比如肩部假肢手术,肱骨骨折后的状态,已经接受手术,因此改变了解剖特征被排除在外,是什么导致了78个研究人口。X射线测量是由两名观察者在真实的前后视图中进行的,这样肱骨头和关节盂显示没有重叠,为关节空间提供清晰的视野。在斜冠状MRI切片中进行MRI测量,使用最准确描绘的关节盂表面作为标志。
结果:观察者间的测量结果显示,根据Bigliani的肩峰类型评估具有统计学意义,p<0.001,根据马洛尼的肱骨头偏移评估,和AHD。在测量左心耳时,观察者间的可靠性没有发现显著性。此外,X射线测量结果与MRI测量结果高度相关,CSA,GH/GA,因此,AI,与AHD有良好的相关性,但与LAA无相关性。
结论:这些发现为评估肩部病理的放射学参数的稳健性提供了有价值的见解,为临床应用和进一步研究提供了有希望的前景。然而,在解释结果时,应考虑特定的方法学考虑因素和患者特征,以确保其在临床实践中的准确应用。
BACKGROUND: The aim of this study was to evaluate the interobserver reliability of measurements of the Acromiohumeral Distance (AHD) first described by Golding et al., the Critical Shoulder Angle (CSA), the Acromion Index with Glenoid Humeral (GH) and Glenoid Acromial (GA) distances, following the measuring method by Nyffeler et al., the Lateral Acromion Angle (LAA), as well as the morphology of the acromion according to Bigliani and the humeral head position according to Maloney in X-rays and MRI. Furthermore, the study assessed the correlation of measurement results in X-ray with those in MRI for AHD, CSA, GA, GH, AI, and LAA.
METHODS: A total of 187 patients who underwent shoulder joint X-ray and MRI examinations from 09/2016 to 05/2023 were included in the study. Patients with poor imaging quality, arthrosis or radical prior surgeries, like shoulder prosthetic surgery, status post humerus fractures, that have undergone surgery and therefore changed the anatomical features were excluded, what lead to a total study population of 78. X-ray measurements were performed by two observers in the true anteroposterior view, so that the humeral head and the glenoid are shown without overlap, providing a clear view into the joint space. MRI measurements were performed in oblique coronal MRI slices, using the most accurately depicted glenoid surface as a landmark.
RESULTS: Interobserver measurement results showed a significance with p < 0.001 for the assessment of acromion type according to Bigliani, humeral head offset assessment according to Maloney, and AHD. No significance was found for interobserver reliability in measuring LAA. Additionally, there was a high correlation of measurement results in X-ray with measurements in MRI for, CSA, GH/GA, and consequently AI, a good correlation for AHD but no correlation could be shown for LAA.
CONCLUSIONS: These findings provide valuable insights into the robustness of radiological parameters for evaluating shoulder pathology, offering promising prospects for clinical applications and further research. Nevertheless, the specific methodological considerations and patient characteristics should be taken into account when interpreting the results to ensure their accurate application in clinical practice.