Three-Dimensional Zero Echo Time Magnetic Resonance Imaging Versus 3-Dimensional Computed Tomography for Glenoid Bone Assessment

Abstract

To evaluate the 3-dimensional (3D) zero echo time (ZTE) magnetic resonance imaging (MRI) technique and compare it with 3D computed tomography (CT) for the assessment of the glenoid bone. ZTE MRI using multiple resolutions and multislice CT were performed in 6 shoulder specimens before and after creation of glenoid defects and in 10 glenohumeral instability patients. Two musculoskeletal radiologists independently generated 3D volume-rendered images of the glenoid en face. Post-processing times and glenoid widths were measured. Inter-modality and inter-rater agreement was assessed. Intraclass correlation coefficients (ICCs) for inter-modality assessment showed almost perfect agreement for both readers, ranging from 0.949 to 0.991 for the exvivo study and from 0.955 to 0.987 for the invivo patients. Excellent interobserver agreement was found for both the exvivo (ICCs ≥ 0.98) and invivo (ICCs ≥ 0.92) studies. For the exvivo study, Bland-Altman analyses for CT versus MRI showed a mean difference of 0.6 to 1 mm at 1.0-mm3 MRI resolution, 0.3 to 0.6 mm at 0.8-mm3 MRI resolution, and 0.3 to 0.6 mm at 0.6-mm3 MRI resolution for both readers. For the invivo study, Bland-Altman analyses for CT versus MRI showed a mean difference of 0.6 to 0.8 mm at 1.0-mm3 MRI resolution, 0.5 to 0.6 mm at 0.8-mm3 MRI resolution, and 0.4 to 0.8 mm at 0.7-mm3 MRI resolution for both readers. Mean post-processing times to generate 3D images of the glenoid ranged from 32 to 46seconds for CT and from 33 to 64 seconds for ZTE MRI. Three-dimensional ZTE MRI can potentially be considered as a technique to determine glenoid width and can be readily incorporated into the clinical workflow. Level II, development of diagnostic criteria (consecutive patients with consistently applied reference standard and blinding).