慢性肩袖病变的MR特点——大体解剖和组织学对照研究  

MR Characterization of Chronic Rotator Cuff Lesion-a Comparison with Gross Anatomy and Histology

作　　者：邓霞[1] 许建荣[1] 李磊[1] 朱建善[2] 

机构地区：[1]上海交通大学医学院附属仁济医院放射科 [2]上海交通大学医学院附属仁济医院病理科

出　　处：《中国医学计算机成像杂志》2008年第5期429-432,共4页Chinese Computed Medical Imaging

摘　　要：目的:与大体解剖和组织学对照,探讨慢性肩袖损伤的MR影像特点。材料和方法:采用Philips Gy- roscant 1.0-NT磁共振扫描仪。对20只人离体肩关节标本进行MR成像。结果:肌腱变性表现为T_1W/ PDW信号增高,无明显形态改变。依据组织学结果,我们将慢性肌腱部分撕裂分为三型:典型撕裂口(Ⅰ型)表现为肌腱撕裂口T_2WI水样高信号;瘢痕型(Ⅱ型)信号表现多样,常表现为T_2序列稍高信号伴肌腱显著增粗,多见于慢性肩袖损伤;肌腱内撕裂(Ⅲ型)与肌腱变性难以区分。肌腱完全撕裂包括"隧道征"、宽大裂口伴或不伴肌腱断端退缩三种表现。结论:慢性肩袖损伤尤其是肩袖部分撕裂的MR表现较为复杂,必须将信号和形态特点相结合慎重诊断。Purpose： To investigate the MR characterization of chronic rotator cuff injury, compared with gross anatomy and histology. Materials and Methods： The study group consisted of 20 cadaver shoulders. All shoulders underwent identical MR examinations on a 1.0T MR unit （Philips Gyroscant 1.0 - NT） . Results： Tendon degeneration was characterized by increased intrasubstance signal on T 1 - weighted or PD - weighted images with normal configuration. According to the histological images, partial - thickness tear had 3 types. Focal area of tendon discontinuity filled with T2 bright fluid signal was the most specific sign of partial - thickness tears （type Ⅰ） . The signal intensity was various, usually slight hyperintense on T2 sequence, in scar - type （type Ⅱ ） with distinctly morphologic changes, which was often seen in cases of chronic injury. It was difficult to differentiate intrasubstance tear （type Ⅲ ） from degeneration. Full - thickness tear showed ＂ tunnel sign＂, defect with or without retraction of the ruptured tendon. Conclusion： MR characterization of chronic rotator cuff injury especially partial tears is very complicated. MR diagnosis must be carefully estimated by combining signal intensity and morphology.

关 键 词：肩袖 变性 撕裂 磁共振成像 组织学 

分 类 号：R445.2[医药卫生—影像医学与核医学]