Is MRI an adequate replacement for CT scans in the three-dimensional assessment of acetabular morphology?
Is MRI an adequate replacement for CT scans in the three-dimensional assessment of acetabular morphology?
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DOI：
10.1177/0284185118795331
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发表时间：
2019-06-01
期刊：
影响因子：
1.3
通讯作者：
Thielemann, Falk
中科院分区：
文献类型：
--
作者：
Goronzy, Jens;Blum, Sophia;Thielemann, Falk
背景适当的髋关节三维成像是计划和实施畸形外科矫正的重要前提。虽然外科医生仍然使用计算机断层扫描(CT)，但使用磁共振成像(MRI)进行骨盆测量的体积成像的现代快速采集技术能够实现类似的分辨率。目的本研究旨在确定已经描述的髋臼形态测量在两种技术中是否具有可比性，以及是否可以以同样的观察者内和观察者间的可靠性进行评估。材料与方法对16例32个髋关节进行3-T骨盆CT和MRI检查。骨盆定位由每位观察者在冠状面、轴面和矢状面标准化。由两名观察者测量髋臼角度和7个髋臼扇角，两次测量间隔至少四周。结果对于CT(0.977-0.999)和磁共振(0.969-0.998)测量髋臼角度和扇形角度，评价员之间的可靠性表现出极好的评分者内和评价员间的可靠性。对每个观察者的CT和MRI的可靠性进行评估，结果显示很好(0.972-0.998)。评估Bland-Altman图的观察者内部可靠性显示，角度的均匀分布在可接受的95%的一致性范围内。在评估CT和MRI的观察者间可靠性以及方法间可靠性方面也观察到了相同的结果。结论现代MRI扫描与CT扫描同样适用于骨盆骨质的评估。此外，MRI还可以在同一检查中检查软组织，如软骨唇结构和肌肉。由于保留髋关节的手术大多是在较年轻的患者中进行的，减少辐射暴露是一种好处。
Background Appropriate three-dimensional imaging of the hip joint is a substantial prerequisite for planning and performing surgical correction of deformities. Although surgeons still use computed tomography (CT), modern and fast acquisition techniques of volumetric imaging using magnetic resonance imaging (MRI) for pelvic measurements enable similar resolution. Purpose This study was designed to determine if already described measures of acetabular morphology are comparable in both techniques and if assessment can be performed with equal intra-observer and inter-observer reliability. Material and Methods Thirty-two hips (16 patients) were examined with a pelvic CT and a MRI with 3-T. Pelvic orientation was standardized by each observer in coronal, axial, and sagittal planes. Acetabular version as well as seven acetabular sector angles were measured by two observers twice with a minimum of four weeks between sessions. Results Inter-rater reliability showed excellent results for intra- and inter-rater reliability for CT (0.977-0.999) and MRI (0.969-0.998) measuring acetabular version and sector angles. Evaluating the reliability of CT and MRI for each observer revealed excellent results (0.972-0.998). Evaluating the Bland-Altman plots for intra-observer reliability showed an equal distribution of angles, within acceptable 95% limits of agreement. The same results were observed for inter-observer reliability evaluating CT and MRI as well as inter-method reliability. Conclusion Modern MRI scans are equally applicable to assess the bony pelvis as CT scans. In addition, MRI would enable the examination of soft tissues such as chondrolabral structures and muscle in the same examination. Since hip-preserving surgery is mostly conducted in younger patients, the reduction of radiation exposure is a benefit.