摘要
目的探讨MRI感兴趣体积（VOI）法三维重建测量三角肌体积的可行性及临床意义。方法回顾性搜集2016年7月至2017年6月因肩痛或肩关节不稳定到我院行肩关节MR检查的78例患者的图像资料，其中肩关节正常者33名，肩袖撕裂22例（男7例、女15例），盂唇及盂唇韧带复合体损伤12例（男11例、女1例），冻结肩9例，肱二头肌长头腱损伤2例。均为2D成像序列，纳入标准为图像矩阵不低于275×336，横轴面扫描范围包括三角肌上、下附着点。病例按年龄分为A组（〈40岁，23例）；B组（40~59岁，40例）；C组（≥ 60岁，15例）。由2名操作者分别采用VOI法测量软件勾画三角肌轮廓，并重建三角肌的三维形态，由软件自动计算三角肌体积。其中1名操作者于1周后重复操作一次，采用组内相关系数（ICC）及其95%置信区间比较2名操作者间及同一操作者在不同时间点测量的可靠性。采用单因素ANOVA分析和LSD组间多重比较法分析不同年龄段受检者三角肌体积的差异。采用分层抽样法以病例组性别比例为基础从正常组中分两次抽取出正常1组和2组。正常1组男9名、女15名，正常2组男13名、女1名,采用Levene方差齐性检验及独立样本t检验比较肩袖撕裂组与肩袖正常1组间及盂唇损伤组与肩袖正常2组间三角肌体积的差异。分析增龄及肩袖损伤、盂唇损伤对三角肌体积的影响。结果MRI VOI法三维重建测量三角肌三维形态显示良好，与解剖所见相符。同一名医师在不同时间点及2名医师间测量结果均显示了很高的一致性（ICC值分别为0.995、0.983）。A、B、C组三角肌体积分别为（382.39±38.87）、（358.49±44.50）、（279.15±63.65）cm3，3组差异有统计学意义（F=22.945，P=0.000）；A组与C组比较、B组与C组比较差异均有统计学意义（P值均〈0.05）；A组与B组比较差异无统计学意义（P=0.057）。肩袖撕裂组三角肌体积（313.21±63.48）cm3小于肩袖正常1组（359.08±57.98）cm3，差异有统计学意义（t=-2.562，P〈0.05）；盂唇损伤组（394.28±33.67）cm3与肩袖正常2组（389.30±22.14）cm3三角肌体积的差异无统计学意义（t=0.385，P=0.704）。结论应用MRI VOI法可简便地测量三角肌体积，可重复性强，可作为骨骼肌体积评价的一种影像手段。
ObjectiveTo explore the feasibility and repeatability of deltoid muscle volume measurement using MR volume of interest method, and discuss the clinical significance.MethodsSeventy-eight subjects＇ MR images were retrospectively reviewed including 33 normal shoulders, 22 rotator cuff tear （7 male, 15 female）, 12 cases with labrum lesions （11 male, 1 female）, and 2 long head of biceps tendon lesions. Routine axial 2D MR images of deltoid muscle were transported into post-processing work station, the matrix of all images were higher than 275×336, and the imaging field included the upper and lower margin of the deltoid muscle, and the three dimension shape of muscle was reconstructed by software based on MR volume of interest, then the muscle volume was calculated automatically. This process was independently performed by 2 operators, and operator 1 repeated this process 1 week later. Intra-class correlation coefficient and 95% confidence interval were used to analyze the reliability and repeatability of the measurement. Deltoid muscle volumes of different ages and different pathological processes were compared using stratified sampling method, one-way analysis of variance （ANOVA）, least significant difference （LSD） multiple comparison method, and independent-samples t test.ResultsThree-dimensional shape of deltoid muscle were well demonstrated and corresponded well to the known anatomy. The measurement showed very good inter-and intra-observer consistency （ICC： 0.983 and 0.995, respectively）. There were statistical differences in deltoid muscle volume between group A and C [volume： （382.39±38.87） cm3 and （279.15±63.65） cm3; P=0.000], group B and C [volume： （358.49±44.50） cm3 and （279.15±63.65） cm3; P=0.000]. The normal participants were divided by gender into normal group 1 （9 males and 15 females） and normal group 2 （13 males and 1 female） using stratified random sampling method. The deltoid muscle volume of patients with rotator cuff tear was lower than the normal group 1 [volume： （313.21±63.48） cm3 versus （359.08±57.98） cm3; t=-2.562, P〈0.05], and there was no statistical difference in deltoid muscle volume between labrum-ligament complex lesions patients and the normal group 2 [volume： （394.28±33.67） cm3 versus （389.30±22.14） cm3; t=0.385, P=0.704].ConclusionsVolume of interest measurement based on routine MR images could evaluate the deltoid muscle volume conveniently and directly, and which could be used as a preferred choice for muscle volume evaluation.
作者
杨献峰
周清清
张卫军
陈艳玲
朱斌
张冰
蒋青
Yang Xianfeng;Zhou Qingqing;Zhang Weijun;Chen Yanling;Zhu Bin;Zhang Bing;Jiang Qing(Department of Medical Imaging,the Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008,China)
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2018年第9期687-691,共5页
Chinese Journal of Radiology
基金
南京市科技发展计划项目（201803026）
江苏省重点研发计划（社会发展）重大科技示范（BE2016605）
关键词
三角肌
磁共振成像
成像
三维
感兴趣体积
Deltoid muscle
Magnetic resonance imaging
Imaging
three-dimensional
Volume of interest
