肩胛下隐窝滑囊积液的MRI征象对肩关节粘连性关节囊炎的诊断价值  

Diagnostic value of MRI symptoms of bursa hydrops in the subscapularis recess for shoulder adhesive capsulitis

作　　者：张杨[1] 陈霖[1] 武文婧[1] 王新[1] 黎海涛[1] 

机构地区：[1]第三军医大学西南医院放射科,重庆400038

出　　处：《局解手术学杂志》2015年第3期295-297,共3页Journal of Regional Anatomy and Operative Surgery

基　　金：国家自然科学基金面上项目(81171283)

摘　　要：目的探讨肩胛下隐窝滑囊积液的MRI征象对肩关节粘连性关节囊炎的诊断价值。方法回顾性分析我院2012年9月至2014年3月157例肩关节的MRI图像,将临床确诊的粘连性关节囊炎冻结期62例作为粘连性关节囊炎组,肩袖部分撕裂31例作为肩袖撕裂组,64例肩关节疼痛未确诊者作为对照组,全部患者在冠状位、矢状位T2WI抑脂像上观察肩胛下隐窝滑囊有无积液征象。结果肩胛下隐窝滑囊积液征象见于粘连性关节囊炎55例(55/62),冈上肌腱部分撕裂4例(4/31),对照组5例(5/64),诊断的准确性、敏感性、特异性、阳性预测值和阴性预测值分别为:0.90、0.89、0.91、0.86、0.92,肩胛下隐窝滑囊积液的MRI征象在诊断粘连性关节囊炎方面与关节镜或手术病理证实的结果一致性好(P<0.001)。结论肩胛下隐窝滑囊积液的MRI征象在确定诊断肩关节粘连性关节囊炎中具有重要价值。Objective To evaluate the diagnostic values of MRI symptoms of bursa hydrops in the subscapularis recess in patients with shoulder adhesive capsulitis. Methods The MRI image of 157 cases recieved from September 2012 to March 2014 were retrospectively ana-lyzed. The 62 cases who were diagnosed as adhesive capsulitis in the freezing phase were regarded as the adhesive capsulitis group; the 31 cases of partial tear of rotator cuff were regarded as the rotator cuff tear group;and the other 64 cases who were undiagnosed were regareded as the control group. The presence of fluid distension of the bursa in the subscapularis recess were evaluated on the T2-weightedfat-saturated images. Results Symptoms of bursa hydrops in the subscapularis recess were found in 55 patients （55/62） with shoulder adhesive capsuli-tis, 4 patients （4/31） with superior cuff tear, and 5 patients （5/64） in the control group. The mean diagnostic values were：veracity 0. 90;sensibility 0. 89;specificity 0. 91;positive predictive value 0. 86; negative predictive value 0. 92. Symptoms of bursa hydrops in the sub-scapularis recess have a good consistency with arthroscopic or pathological results （P〈0. 001）. Conclusion The MRI symptoms of bursa hydrops in the subscapularis recess has an important diagnostic value for the confirmation of shoulder adhesive capsulitis.

关 键 词：肩关节 粘连性关节囊炎 肩胛下隐窝 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]