直接数字化X线摄影与MRI在肩峰下撞击综合征诊断中的应用价值  

The clinical value of direct digital radiography(DR)and MRI in the diagnosis of subacromial impingement syndrome

作　　者：何荣兴[1] 覃浩玲[1] 赵晓晓 陈应明[1] 林尔坚[1] 孙海兴[1] HE Rongxing;QIN Haoling;ZHAO Xiaoxiao;CHEN Yingming;LIN Eijian;SUN Haixing(Department of Radiology,the Eastern Hospital of First Affiliated Hospital,Sun Yat Sen University,Guangzhou 510700,China)

机构地区：[1]中山大学附属第一医院东院放射科,广州510700

出　　处：《功能与分子医学影像学（电子版）》2019年第4期1740-1744,共5页Functional and Molecular Medical Imaging(Electronic Edition)

摘　　要：目的探讨直接数字化X线摄影(DR)与MRI在肩峰下撞击综合征(SIS)诊断中的价值.方法回顾性分析2016年1月~2019年6月经我院临床确诊的SIS患者60例,所有患者均行DR与MRI检查,观察肩峰形态、最短肩肱间隙(AHD),对比分析两种检查的影像学表现.结果DR诊断准确率为65.0%(39/60),明显低于MRI的96.7%(58/60),两者准确率差异具有统计学意义(P<0.05).结论与DR相比,MRI的软组织分辨率、诊断准确率更高,对观察肩关节冈上肌肌腱、肩峰下滑囊积液、盂唇撕裂及肩袖撕裂更为理想,但对于肩峰下及肩锁关节骨质增生、骨赘形成、韧带钙化及肩峰段形态分类不如DR空间分辨率高、直观、清晰.两种方法联合应用可为临床诊疗提供更多影像学依据.Objective To evaluate the diagnostic value of direct digital radiography(DR)and MRI in subacromial impingement syndrome.Methods A retrospective analysis was performed on 60 patients with subacromial impinging syndrome diagnosed clinically in our hospital from January 2016 to June 2019.All patients underwent DR and MRI examinations to observe the acromial morphology and the shortest acromial humeral space(AHD),and the manifestations of the two examinations were compared and analyzed.Results The diagnostic accuracy of DR was 65.0%(39/60),which was significantly lower than that of MRI(96.7%,58/60,P<0.05).Conclusions Compared with DR,the soft tissue resolution and diagnostic accuracy of MRI is higher.The observation of the supraspinatus tendon,shoulder capsule effusion,spoon lips tear,rotator cuff tear can be seen more clearly,but for the acromion and acromioclavicular joint hyperplasia,osteophyte,ligament calcification and acromion morphological classification,DR images are more intuitive and clear,also has more advantage than MR with higher spatial resolution.The combination of the two methods can provide more imaging evidence for clinical diagnosis and treatment.

关 键 词：肩峰下撞击综合征 直接数字化X线摄影 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R445.4[医药卫生—诊断学]