高频超声对冻结肩的诊断价值  

Value of high frequency ultrasound for assessment of frozen shoulder

作　　者：郭璇妍[1] 卢漫[1] 成雪晴 贺凡丁[1] 陈凯[1] 吴艳艳[1] 

机构地区：[1]四川省医学科学院.四川省人民医院超声科,成都610072

出　　处：《中华医学超声杂志（电子版）》2016年第4期258-261,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨高频超声对冻结肩的诊断价值。方法对2014年4月至2015年10月四川省人民医院临床诊断为冻结肩的患者57例,共63个患肩,行肩关节超声检查。同期对无任何肩关节症状者25例,共50个肩关节,行超声检查作为对照组。肩关节超声检查时测量喙肱韧带（CHL）及盂肱关节囊厚度,观察肩袖间隙的回声、厚度及血流信号,肱二头肌长头腱腱鞘有无积液及血流等。结果冻结肩组63个肩关节平均CHL及关节囊厚度较对照组明显增厚[（3.00±0.65）mm vs（1.30±0.56）mm,（3.60±0.97）mm vs（1.80±0.65）mm,P值均〈0.01]。对照组50个肩关节肩袖间隙未见明显异常,而冻结肩组患者24个肩关节（38.1%）肩袖间隙回声减低、增厚伴点状彩色血流信号,差异具有统计学意义（χ^2=24.18,P〈0.01）。冻结肩组57个（90.5%）肩关节肱二头肌长头腱鞘积液,其中25（43.9%）个肱二头肌长头腱鞘增厚伴或不伴点状血流信号,对照组肱二头肌长头腱鞘未见明显异常,差异具有统计学意义（χ^2=91.28,P〈0.01）。结论高频超声可准确评估冻结肩患者喙肱韧带及关节囊增厚、肩袖间隙回声及血流信号变化等,对冻结肩的诊断具有重要作用。Objective To detect the value of high frequency ultrasound for assessment of frozen shoulder. Methods Sixty-three involved shoulders of 57 frozen shoulder patients diagnosed by an orthopaedic doctor from April 2014 to October 2015 in Sichuan Provincial Peoples′ Hospital were included in this study. There were also 50 shoulders of 25 patients without any shoulder symptoms included into the control group at the same time. Shoulder ultrasound was performed to measure the thickness of coracohumeral ligament（CHL） and glenohumeral capsule, to count the abnormality of echotexture, thickness and blood flow in rotator cuff interval, and the abnormality of the sheath of biceps tendon for all participants. Results The mean thickness of CHL and capsule in the patient group were greater than that in the control group [（3.00±0.65） mm vs（1.30±0.56） mm,（3.60±0.97） mm vs（1.80±0.65） mm, both P0.01]. Ultrasound didn′t detect any abnormality at the rotator cuff interval among all 50 shoulders in the control group. While 24 cases were detected an decreased echotexture with increased thickness and blood flow in the rotator cuff interval, with a greater detecting rates than the control group in the patient group（χ~2=24.18, P 〈0.01）. There were 57 cases detected with significant effusion around the biceps tendon, 25（43.9%） of them also demonstrated a thickened sheath of biceps tendon with or without blood flow in the patient group. But there was no significant effusion around the biceps tendon in the control group（χ~2=91.28, P 〈0.01）. Conclusion Highfrequency ultrasound could be used to assess the thickening of CHL and capsule, the abnormality of rotator cuff interval and sheath of biceps tendon, which is very important to the diagnosis of frozen shoulder.

关 键 词：超声检查 肩关节 粘连性关节囊炎 

分 类 号：R445.1[医药卫生—影像医学与核医学] R686[医药卫生—诊断学]