Voxel-based Three-dimensional Segmentation of the Capsulo-synovium from Contrast-enhanced MRI Can Represent Clinical Impairments in Adhesive Capsulitis

Jung-Sang Lee,Seoung Wan Chae,Kyung Jae Yoon,Yong-Taek Lee,Jong Geol Do,Hee-Jin Park,Chul-Hyun Park

doi:10.1038/s41598-020-63406-9

Jung-Sang Lee, Seoung Wan Chae + Show 5 more

Open Access

https://doi.org/10.1038/s41598-020-63406-9

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Abstract

The purposes were to calculate total voxel volume of the entire capsulo-synovial enhanced portion on contrast-enhanced (CE) MRI in adhesive capsulitis, and to investigate its association with glenohumeral joint volume and passive range of motions (ROMs), which are a well-known diagnostic reference standard and clinical hallmark of this condition. Medical records of 169 consecutive patients who underwent ultrasound-guided intraarticular injection with adhesive capsulitis and CE-MRI to exclude other mimicking shoulder diseases were retrospectively reviewed. To calculate total voxel volume of entire capsulo-synovial enhanced portion on CE-MRI, voxel-based 3-dimensional (3D) segmentation was obtained semi-automatically using Fiji, an open-source image processing software. Pearson’s correlation coefficients were analyzed. Sixty patients who met eligibility criteria were included. Total voxel volume showed a significant inverse correlation with the glenohumeral joint volume (r = −0.528, P < 0.001), forward elevation, external rotation, and abduction (r = −0.407, P = 0.001; r = −0.342, P = 0.007; r = −0.275, P = 0.034, respectively). Intra-observer and inter-observer reliabilities, measured by intraclass correlation coefficients (ICC), were excellent (ICC = 0.87 and 0.77, respectively). This study’s results indicate that voxel-based 3D segmentation of entire capsulo-synovial enhanced portion from CE-MRI can represent the severity of clinical impairments, such as obliterated joint volume and limited passive ROMs in adhesive capsulitis.

Highlights

Degrees of severity according to the disease stage (Fig. 1)[1,9,13,14]
We reviewed the medical records of 169 consecutive patients who presented to the outpatient shoulder clinic of our department with a clinical diagnosis of adhesive capsulitis and who underwent ultrasound-guided intra-articular injection and CE-MRI to exclude other mimicking shoulder diseases between January 2007 and July 2017
All passive range of motions (ROMs) values, which are well-known clinical hallmarks of this condition, were inversely correlated with the total voxel volume of the entire capsulo-synovial enhanced portion on CE-MRI. Both intra-observer and inter-observer reliabilities, analyzed by the intraclass correlation coefficients (ICC), were excellent. These findings indicate that the voxel-based 3D assessment of the capsulo-synovial enhancement on CE-MRI can represent www.nature.com/scientificreports severity of clinical impairments in adhesive capsulitis, such as obliterated joint volume and limitation of passive ROMs

Summary

Introduction

Degrees of severity according to the disease stage (Fig. 1)[1,9,13,14]. we hypothesized that a three-dimensional (3D) quantification of the entire capsulo-synovial enhanced portion would provide reliable and exact information about the pathologic status of the joint in adhesive capsulitis. The purposes of this study were to calculate the total voxel volume of the entire capsulo-synovial enhanced portion on contrast-enhanced (CE)-MRI in adhesive capsulitis, and to investigate its association with the glenohumeral joint volume and passive ROMs, which are a well-known diagnostic reference standard and clinical hallmark of this condition, respectively

Methods

Results

Conclusion