Study on the evaluation of glenoid bone defects by MRI three-dimensional reconstruction_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANG Fei ^1,2 , XU Lin ³ , ZHANG Baoxiang ^1,2 , SONG Shoulong ^1,2 , SHENG Xianhao ^1,2 , XIONG Wentao ^1,4 , WANG Ziran ⁵ , LIAO Weixiong ⁶ ,  ZHANG Qiang ²

1. Chinese PLA Medical School, Beijing, 100853, P. R. China;
2. Department of Orthopedic Surgery, Chinese PLA General Hospital, Beijing, 100853, P. R. China;
3. Department of Radiology, Chinese PLA General Hospital, Beijing, 100853, P. R. China;
4. Department of Orthopedic Surgery, Hainan Hospital of Chinese PLA General Hospital, Sanya Hainan, 572013, P. R. China;
5. Department of Orthopedic Surgery, the 903rd Hospital of Chinese PLA, Hangzhou Zhejiang, 310013, P. R. China;
6. Department of Emergency, Chinese PLA General Hospital, Beijing, 100853, P. R. China;

Corresponding author：

ZHANG Qiang, Email: 301zq@live.cn

Keywords：

Shoulder dislocation; glenoid bone defect; MRI three-dimensional reconstruction; CT three-dimensional reconstruction

DOI：

10.7507/1002-1892.202301050

Video：

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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.

Citation： ZHANG Fei, XU Lin, ZHANG Baoxiang, SONG Shoulong, SHENG Xianhao, XIONG Wentao, WANG Ziran, LIAO Weixiong, ZHANG Qiang. Study on the evaluation of glenoid bone defects by MRI three-dimensional reconstruction. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(5): 551-555. doi: 10.7507/1002-1892.202301050 Copy

1.	Burkhead WZ Jr, Rockwood CA Jr. Treatment of instability of the shoulder with an exercise program. J Bone Joint Surg (Am), 1992, 74(6): 890-896.
2.	Dickens JF, Slaven SE, Cameron KL, et al. Prospective evaluation of glenoid bone loss after first-time and recurrent anterior glenohumeral instability events. Am J Sports Med, 2019, 47(5): 1082-1089.
3.	Boileau P, Villalba M, Héry JY, et al. Risk factors for recurrence of shoulder instability after arthroscopic Bankart repair. J Bone Joint Surg (Am), 2006, 88(8): 1755-1763.
4.	Itoi E, Lee SB, Berglund LJ, et al. The effect of a glenoid defect on anteroinferior stability of the shoulder after Bankart repair: a cadaveric study. J Bone Joint Surg (Am), 2000, 82(1): 35-46.
5.	Wermers J, Schliemann B, Raschke MJ, et al. Glenoid concavity has a higher impact on shoulder stability than the size of a bony defect. Knee Surg Sports Traumatol Arthrosc, 2021, 29(8): 2631-2639.
6.	Min KS, Sy JW, Mannino BJ. Area measurement percentile of 3-dimensional computed tomography has the highest interobserver reliability when measuring anterior glenoid bone loss. Arthroscopy, 2023, S0749-8063(23)00018-X. doi: 10.1016/j.arthro.2022.12.035.
7.	Zappia M, Albano D, Aliprandi A, et al. Glenoid bone loss in anterior shoulder dislocation: a multicentric study to assess the most reliable imaging method. Radiol Med, 2023, 128(1): 93-102.
8.	潘正烽, 黄富国, 李箭, 等. 肩关节前向不稳中骨缺损诊断技术及评估方法的研究进展. 中国修复重建外科杂志, 2019, 33(6): 762-767.
9.	Rayes J, Xu J, Sparavalo S, et al. Calculating glenoid bone loss based on glenoid height using ipsilateral three-dimensional computed tomography. Knee Surg Sports Traumatol Arthrosc, 2023, 31(1): 169-176.
10.	Vopat ML, Hermanns CA, Midtgaard KS, et al. Imaging modalities for the glenoid track in recurrent shoulder instability: a systematic review. Orthop J Sports Med, 2021, 9(6): 23259671211006750. doi: 10.1177/23259671211006750.
11.	Martin CJ, Barnard M. Potential risks of cardiovascular and cerebrovascular disease and cancer due to cumulative doses received from diagnostic CT scans? J Radiol Prot, 2021, 41(4). doi: 10.1088/1361-6498/ac270f.
12.	Ver Berne J, Politis C, Shaheen E, et al. Cumulative exposure and lifetime cancer risk from diagnostic radiation in patients undergoing orthognathic surgery: a cross-sectional analysis. Int J Oral Maxillofac Surg, 2023, S0901-5027(23)00025-5. doi: 10.1016/j.ijom.2023.02.001.
13.	Cao CF, Ma KL, Shan H, et al. CT Scans and cancer risks: a systematic review and dose-response meta-analysis. BMC Cancer, 2022, 22(1): 1238. doi: 10.1186/s12885-022-10310-2.
14.	Lee RK, Griffith JF, Tong MM, et al. Glenoid bone loss: assessment with MR imaging. Radiology, 2013, 267(2): 496-502.
15.	Florkow MC, Willemsen K, Mascarenhas VV, et al. Magnetic resonance imaging versus computed tomography for three-dimensional bone imaging of musculoskeletal pathologies: a review. J Magn Reson Imaging, 2022, 56(1): 11-34.
16.	Sgroi M, Huzurudin H, Ludwig M, et al. MRI allows accurate measurement of glenoid bone loss. Clin Orthop Relat Res, 2022, 480(9): 1731-1742.
17.	Yan K, Xi Y, Sasiponganan C, et al. Does 3DMR provide equivalent information as 3DCT for the pre-operative evaluation of adult hip pain conditions of femoroacetabular impingement and hip dysplasia? Br J Radiol, 2018, 91(1092): 20180474. doi: 10.1259/bjr.20180474.
18.	Kralik SF, Supakul N, Wu IC, et al. Black bone MRI with 3D reconstruction for the detection of skull fractures in children with suspected abusive head trauma. Neuroradiology, 2019, 61(1): 81-87.
19.	Eismann EA, Laor T, Cornwall R. Three-dimensional magnetic resonance imaging of glenohumeral dysplasia in neonatal brachial plexus palsy. J Bone Joint Surg (Am), 2016, 98(2): 142-151.
20.	Sugaya H, Moriishi J, Dohi M, et al. Glenoid rim morphology in recurrent anterior glenohumeral instability. J Bone Joint Surg (Am), 2003, 85(5): 878-884.
21.	Gyftopoulos S, Hasan S, Bencardino J, et al. Diagnostic accuracy of MRI in the measurement of glenoid bone loss. AJR Am J Roentgenol, 2012, 199(4): 873-878.
22.	Kwon YW, Powell KA, Yum JK, et al. Use of three-dimensional computed tomography for the analysis of the glenoid anatomy. J Shoulder Elbow Surg, 2005, 14(1): 85-90.
23.	Arenas-Miquelez A, Dabirrahmani D, Sharma G, et al. What is the most reliable method of measuring glenoid bone loss in anterior glenohumeral instability? A cadaveric study comparing different measurement techniques for glenoid bone loss. Am J Sports Med, 2021, 49(13): 3628-3637.
24.	Heckelman LN, Soher BJ, Spritzer CE, et al. Design and validation of a semi-automatic bone segmentation algorithm from MRI to improve research efficiency. Sci Rep, 2022, 12(1): 7825. doi: 10.1038/s41598-022-11785-6.
25.	Davico G, Bottin F, Di Martino A, et al. Intra-operator repeatability of manual segmentations of the hip muscles on clinical magnetic resonance images. J Digit Imaging, 2023, 36(1): 143-152.
26.	Lacheta L, Herbst E, Voss A, et al. Insufficient consensus regarding circle size and bone loss width using the ratio-“best fit circle”-method even with three-dimensional computed tomography. Knee Surg Sports Traumatol Arthrosc, 2019, 27(10): 3222-3229.
27.	Do WS, Kim JH, Lim JR, et al. Disagreement between the accepted best-fit circle method to calculate bone loss between injured and uninjured shoulders. Am J Sports Med, 2023. doi: 10.1177/03635465221149743.
28.	Moroder P, Plachel F, Huettner A, et al. The effect of scapula tilt and best-fit circle placement when measuring glenoid bone loss in shoulder instability patients. Arthroscopy, 2018, 34(2): 398-404.
29.	Ma Y, Jang H, Jerban S, et al. Making the invisible visible-ultrashort echo time magnetic resonance imaging: Technical developments and applications. Appl Phys Rev, 2022, 9(4): 041303. doi: 10.1063/5.0086459.

1. Burkhead WZ Jr, Rockwood CA Jr. Treatment of instability of the shoulder with an exercise program. J Bone Joint Surg (Am), 1992, 74(6): 890-896.
2. Dickens JF, Slaven SE, Cameron KL, et al. Prospective evaluation of glenoid bone loss after first-time and recurrent anterior glenohumeral instability events. Am J Sports Med, 2019, 47(5): 1082-1089.
3. Boileau P, Villalba M, Héry JY, et al. Risk factors for recurrence of shoulder instability after arthroscopic Bankart repair. J Bone Joint Surg (Am), 2006, 88(8): 1755-1763.
4. Itoi E, Lee SB, Berglund LJ, et al. The effect of a glenoid defect on anteroinferior stability of the shoulder after Bankart repair: a cadaveric study. J Bone Joint Surg (Am), 2000, 82(1): 35-46.
5. Wermers J, Schliemann B, Raschke MJ, et al. Glenoid concavity has a higher impact on shoulder stability than the size of a bony defect. Knee Surg Sports Traumatol Arthrosc, 2021, 29(8): 2631-2639.
6. Min KS, Sy JW, Mannino BJ. Area measurement percentile of 3-dimensional computed tomography has the highest interobserver reliability when measuring anterior glenoid bone loss. Arthroscopy, 2023, S0749-8063(23)00018-X. doi: 10.1016/j.arthro.2022.12.035.
7. Zappia M, Albano D, Aliprandi A, et al. Glenoid bone loss in anterior shoulder dislocation: a multicentric study to assess the most reliable imaging method. Radiol Med, 2023, 128(1): 93-102.
8. 潘正烽, 黄富国, 李箭, 等. 肩关节前向不稳中骨缺损诊断技术及评估方法的研究进展. 中国修复重建外科杂志, 2019, 33(6): 762-767.
9. Rayes J, Xu J, Sparavalo S, et al. Calculating glenoid bone loss based on glenoid height using ipsilateral three-dimensional computed tomography. Knee Surg Sports Traumatol Arthrosc, 2023, 31(1): 169-176.
10. Vopat ML, Hermanns CA, Midtgaard KS, et al. Imaging modalities for the glenoid track in recurrent shoulder instability: a systematic review. Orthop J Sports Med, 2021, 9(6): 23259671211006750. doi: 10.1177/23259671211006750.
11. Martin CJ, Barnard M. Potential risks of cardiovascular and cerebrovascular disease and cancer due to cumulative doses received from diagnostic CT scans? J Radiol Prot, 2021, 41(4). doi: 10.1088/1361-6498/ac270f.
12. Ver Berne J, Politis C, Shaheen E, et al. Cumulative exposure and lifetime cancer risk from diagnostic radiation in patients undergoing orthognathic surgery: a cross-sectional analysis. Int J Oral Maxillofac Surg, 2023, S0901-5027(23)00025-5. doi: 10.1016/j.ijom.2023.02.001.
13. Cao CF, Ma KL, Shan H, et al. CT Scans and cancer risks: a systematic review and dose-response meta-analysis. BMC Cancer, 2022, 22(1): 1238. doi: 10.1186/s12885-022-10310-2.
14. Lee RK, Griffith JF, Tong MM, et al. Glenoid bone loss: assessment with MR imaging. Radiology, 2013, 267(2): 496-502.
15. Florkow MC, Willemsen K, Mascarenhas VV, et al. Magnetic resonance imaging versus computed tomography for three-dimensional bone imaging of musculoskeletal pathologies: a review. J Magn Reson Imaging, 2022, 56(1): 11-34.
16. Sgroi M, Huzurudin H, Ludwig M, et al. MRI allows accurate measurement of glenoid bone loss. Clin Orthop Relat Res, 2022, 480(9): 1731-1742.
17. Yan K, Xi Y, Sasiponganan C, et al. Does 3DMR provide equivalent information as 3DCT for the pre-operative evaluation of adult hip pain conditions of femoroacetabular impingement and hip dysplasia? Br J Radiol, 2018, 91(1092): 20180474. doi: 10.1259/bjr.20180474.
18. Kralik SF, Supakul N, Wu IC, et al. Black bone MRI with 3D reconstruction for the detection of skull fractures in children with suspected abusive head trauma. Neuroradiology, 2019, 61(1): 81-87.
19. Eismann EA, Laor T, Cornwall R. Three-dimensional magnetic resonance imaging of glenohumeral dysplasia in neonatal brachial plexus palsy. J Bone Joint Surg (Am), 2016, 98(2): 142-151.
20. Sugaya H, Moriishi J, Dohi M, et al. Glenoid rim morphology in recurrent anterior glenohumeral instability. J Bone Joint Surg (Am), 2003, 85(5): 878-884.
21. Gyftopoulos S, Hasan S, Bencardino J, et al. Diagnostic accuracy of MRI in the measurement of glenoid bone loss. AJR Am J Roentgenol, 2012, 199(4): 873-878.
22. Kwon YW, Powell KA, Yum JK, et al. Use of three-dimensional computed tomography for the analysis of the glenoid anatomy. J Shoulder Elbow Surg, 2005, 14(1): 85-90.
23. Arenas-Miquelez A, Dabirrahmani D, Sharma G, et al. What is the most reliable method of measuring glenoid bone loss in anterior glenohumeral instability? A cadaveric study comparing different measurement techniques for glenoid bone loss. Am J Sports Med, 2021, 49(13): 3628-3637.
24. Heckelman LN, Soher BJ, Spritzer CE, et al. Design and validation of a semi-automatic bone segmentation algorithm from MRI to improve research efficiency. Sci Rep, 2022, 12(1): 7825. doi: 10.1038/s41598-022-11785-6.
25. Davico G, Bottin F, Di Martino A, et al. Intra-operator repeatability of manual segmentations of the hip muscles on clinical magnetic resonance images. J Digit Imaging, 2023, 36(1): 143-152.
26. Lacheta L, Herbst E, Voss A, et al. Insufficient consensus regarding circle size and bone loss width using the ratio-“best fit circle”-method even with three-dimensional computed tomography. Knee Surg Sports Traumatol Arthrosc, 2019, 27(10): 3222-3229.
27. Do WS, Kim JH, Lim JR, et al. Disagreement between the accepted best-fit circle method to calculate bone loss between injured and uninjured shoulders. Am J Sports Med, 2023. doi: 10.1177/03635465221149743.
28. Moroder P, Plachel F, Huettner A, et al. The effect of scapula tilt and best-fit circle placement when measuring glenoid bone loss in shoulder instability patients. Arthroscopy, 2018, 34(2): 398-404.
29. Ma Y, Jang H, Jerban S, et al. Making the invisible visible-ultrashort echo time magnetic resonance imaging: Technical developments and applications. Appl Phys Rev, 2022, 9(4): 041303. doi: 10.1063/5.0086459.

Chinese Journal of Reparative and Reconstructive Surgery

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

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