集成MRI技术在冈上肌肌腱损伤分级中的定量价值  

Quantitative study of supraspinatus tendon injury grading based on synthetic magnetic resonance imaging

作　　者：倪亚博 田兆荣[1] 杨建平 王玉琪 田博[1] 龚瑞[1] 赵薇[2] 王志军[1] Ni Yabo;Tian Zhaorong;Yang Jianping;Wang Yuqi;Tian Bo;Gong Rui;Zhao Wei;Wang Zhijun(Department of Radiology,General Hospital of Ningxia Medical University,Yinchuan 750001,China;Basic Medical College of Ningxia Medical University,Yinchuan 750001,China)

机构地区：[1]宁夏医科大学总医院放射科,银川750001 [2]宁夏医科大学基础医学院,银川750001

出　　处：《中华医学杂志》2023年第21期1603-1610,共8页National Medical Journal of China

基　　金：国家自然科学基金(81260460);宁夏回族自治区重点研发项目(2021BEG03033)

摘　　要：目的探讨集成MRI(SyMRI)技术在冈上肌肌腱损伤分级中的定量价值。方法前瞻性招募2021年7月至2022年7月宁夏医科大学总医院门诊确诊冈上肌肌腱损伤的97例患者(病例组),男54例,女43例,年龄29~56(37.4±9.6)岁。病例组患者根据肩关节镜结果分为3个亚组:肌腱病组(37例,Ⅱ级)、部分撕裂组(34例,Ⅲ级)及完全撕裂组(26例,Ⅳ级)。同期招募无冈上肌肌腱损伤的正常肩袖志愿者28名(对照组),男16名,女12名,年龄23~49(36.1±7.2)岁,分级为Ⅰ级。所有受试者均接受肩关节MRI轴位T_(1)加权像(T_(1)WI)快速自旋回波序列、轴位T_(2)加权像(T_(2)WI)脂肪抑制(FS)序列、斜冠状位T_(2)WI FS及斜矢状位质子密度加权(PDW)序列扫描,同时行SyMRI序列斜冠状位扫描。于T_(2)WI斜冠状位图像上根据冈上肌肌腱走形将其分为外侧、内侧及中间亚区,由2名放射科医生测量3个亚区的T_(1)、T_(2)及PD值。采用组内相关系数(ICC)评估观察者间及观察者内的一致性。采用单因素方差分析或Kruskal-Wallis H检验比较不同分级各定量参数的差异。采用多因素logistic回归模型分析冈上肌肌腱损伤分级的危险因素,并绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC),评价其诊断效能。采用Spearman相关性分析各定量值与损伤分级的相关性。结果冈上肌肌腱3个亚区T_(1)、T_(2)及PD值的观察者间及观察者内ICC值均>0.700。外侧亚区的T_(1)值、外侧及中间亚区的T_(2)值在冈上肌肌腱损伤不同分级中的总体比较差异有统计学意义(均P<0.001),中间及内侧亚区的T_(1)值、内侧亚区的T_(2)值及外侧、中间及内侧亚区的PD值在冈上肌肌腱损伤不同分级中的总体比较差异均无统计学意义(均P>0.05)。多因素logistic回归模型分析结果显示外侧及中间亚区的T_(2)值是冈上肌肌腱损伤分级的相关因素[OR值(95%CI)分别为1.123(1.037~1.216)、0.122(1.151~1.197);均P<0.001]。外�Objective To investigate the diagnostic value of quantitative parameters of synthetic magnetic resonance imaging(SyMRI)in the grade of supraspinatus tendon injury.Methods Ninety-seven patients with clinical definite of supraspinatus tendon injury from July 2021 to July 2022 in General Hospital of Ningxia Medical University were prospectively collected(case group),including 54 males and 43 females,with an age of 29 to 56(37.4±9.6)years.According to the results of shoulder arthroscopy,the case group were divided into three subgroups included tendinopathy group(37 cases,gradeⅡ),partial tear group(34 cases,gradeⅢ)and complete tear group(26 cases,gradeⅣ).During the same period,28 normal rotator cuff volunteers without supraspinatus tendon injury were recruited(control group),including 16 males and 12 females,aged 23 to 49(36.1±7.2)years,and marked as gradeⅠ.All the subjects underwent MRI scan of articulatio humeri included T_(1)-weighted imaging(T_(1)WI)fast spin echo(FSE)sequences in axial view,T_(2)-weighted imaging(T_(2)WI)fat suppression(FS)sequences in axial view,T_(2)WI FS sequences in oblique coronal view,proton density-weighted(PDW)imaging in oblique sagittal view and SyMRI in oblique coronal view.The supraspinatus tendon was divided into lateral,medial and middle subregions according to its shape in oblique coronal T_(2)WI view,two radiologists measured the T_(1),T_(2)and PD values of the supraspinatus tendon.The interclass correlation coefficient(ICC)were used to compare the consistency between and within observers.One-way analysis of variance or Kruskal-Wallis H test were used to compare the differences of quantitative parameters in different grades,the multivariate logistic regression model was used to analyze the risk factors of supraspinatus tendon injury grade,and the receiver operating characteristic(ROC)curves and area under curve(AUC)was drawn and calculated to evaluate the diagnostic efficacy.The Spearman correlation was used to analyze the correlation between the quantitative values and g

关 键 词：放射学 定量磁共振成像 肩袖损伤 肌腱变性 合成磁共振成像 横断面研究 

分 类 号：R686.1[医药卫生—骨科学]