MSCT与MRI在肩峰下撞击综合症诊断中的应用价值  

Study on the subacromial impingement syndrome acromion somatotype with multi-slice CT and MRI

作　　者：江凯[1] 叶如卿[2] 王蓼[1] 葛明亮[1] 邓生德[1] 

机构地区：[1]浙江省宁波大学医学院附属医院放射科,315020 [2]浙江省宁波大学医学院附属医院骨关节科,315020

出　　处：《中华全科医学》2015年第5期800-803,共4页Chinese Journal of General Practice

基　　金：浙江省宁波市社会发展科研项目(2012C50002)

摘　　要：目的肩峰下撞击综合症是致肩关节功能受限的主要原因,常用X线检查,但图像重叠,细节显示差,为满足临床,本研究探讨MSCT与MRI的应用价值,以期为诊治提供更好的影像学依据。方法选择经临床证实的97例患者,共97肩行MSCT及MRI扫描。按年龄分A组（39岁以下）、B组（40～59岁）和C组（60岁以上）;按部位分左、右肩组;按A-H间距分（a组〉10 mm;b组5～10 mm;c组〈5 mm）组;按各型肩峰肩袖有无损伤分3组。将MSCT数据1 mm薄层重建后在工作站上行容积再现、多平面重组处理;MRI斜冠状位及横断位观察肩袖情况。结果 MSCT：Ⅰ型23肩,Ⅱ型30肩,Ⅲ型44肩;Ⅰ、Ⅱ型随年龄增加减少,Ⅲ型随年龄增加增加,A、B组Ⅱ、Ⅲ型比例差异有统计学意义,A、C组Ⅱ、Ⅲ型差异有统计学意义;Ⅲ型以右肩居多,左右肩Ⅲ型差异有统计学意义;Ⅰ、Ⅲ型及Ⅱ、Ⅲ型A-H间距c组差异有统计学意义,Ⅲ型所占比例最高。MRI：Ⅰ型肩袖损伤8肩,无15肩;Ⅱ型损伤17肩,无13肩;Ⅲ型损伤39肩,无5肩;Ⅲ型与Ⅰ、Ⅱ型肩袖损伤所占比例差异有统计学意义。结论 MSCT可清晰显示肩峰形态,Ⅲ型右肩多见,随年龄增加增加,撞击综合症的发生率明显高于其他两型;MRI可弥补MSCT不足,清晰显示肩袖,Ⅲ型较Ⅰ、Ⅱ型易致肩袖损伤。MSCT、MRI可为诊治提供更好的影像学依据。Objective Subacromial impingement syndrome was the main reason to cause the shoulder joint function limitation,X-ray examination was commonly used,but the image overlapped,with weak details show,in order to meet the needs of clinical,this study explored the application value of MSCT and MRI,to provide a better basis for the diagnosis and treatment of imaging. Methods 97 cases of clinical confirmed patients were selected,97 underwent MSCT and MRI scans of the shoulder. According to the age,group A（ age 39）,B group（ 40- 59 years old） and group C（ aged over 60）were set; according to the site,they were divided into a left,right shoulder group; according to A-H spacing,they were divided into（ a group 〉10 mm; b group 5- 10 mm; c group 〈5 mm） three groups by the type of the acromion; rotator cuff without injury were divided into three groups. The MSCT data 1mm reconstruction in workstation uplink volume rendering,multi planar reconstruction and MRI oblique coronal and axial of rotator cuff situation were observed. Results MSCT：type Ⅰ 23 shoulder,30 type Ⅱ,44 of type Ⅲ shoulder; Ⅰ,Ⅱ ratio decreased with the increase of age,type Ⅲ increased with age,there was statistical significance in A,B in group Ⅱ,Ⅲ ratio difference,with significant A,C in group Ⅱ,Ⅲtype difference; type Ⅲ to the right shoulder had statistically significant differences around the shoulder type Ⅲ; there was significant difference between 5mm group Ⅰ,Ⅲ and Ⅱ,Ⅲ A-H spacing（ P〈0. 05）,type Ⅲ had the highest proportion.MRI： type Ⅰ rotator cuff injury 8 shoulders,no injury in 15 shoulders; 17 shoulder injury type II,no injury in 13 shoulders; 39 shoulder injury type Ⅲ,no injury in 5 shoulders; Ⅲ and Ⅰ,Ⅱ rotator cuff injury differences in the proportion was significant. Conclusion MSCT can clearly show the acromial morphology,type Ⅲ subacromial shoulder was common,and increased with age,impingement syndrome were significantly higher than those of other type two; MRI can make up for the

关 键 词：肩峰下撞击综合症 肩峰分型 MSCT MRI 

分 类 号：R814.42[医药卫生—影像医学与核医学] R681.7[医药卫生—放射医学]