肩周炎MRI征象与其临床分期的关系  

The diagnostic value of MRI signs of scapulohumeral periarthritis in its clinical staging

作　　者：魏骥荣 唐维 WEI Jirong;TANG Wei(Department of Medical Imaging,the 4th Hospital of Changsha,Changsha,Hunan 410006,China)

机构地区：[1]长沙市第四医院医学影像科,湖南长沙410006

出　　处：《影像研究与医学应用》2023年第13期52-55,59,共5页Journal of Imaging Research and Medical Applications

摘　　要：目的:分析探讨肩周炎MRI征象(腋窝关节囊厚度、喙肱韧带厚度以及喙突下脂肪三角受累情况)与肩周炎分期之间的关系。方法:回顾性分析长沙市第四医院2016年8月-2022年8月经临床诊断为肩周炎的72例患者(观察组)、同期12名正常健康人群(对照组)的MRI影像表现,记录喙肱韧带厚度、腋窝关节囊厚度以及喙突下脂肪三角被瘢痕组织取代率。结果:(1)观察组与对照组腋窝关节囊厚度、喙肱韧带厚度以及喙突下脂肪三角受累情况进行比较,差异存在统计学意义(P <0.05);(2)腋窝关节囊厚度在观察组第1、2、3期之间两两比较,差异具有统计学意义(P <0.05);(3)喙肱韧带厚度、喙突下脂肪三角被瘢痕取代比率在观察组第1、2、3期之间两两相比,差异均无统计学意义(P> 0.05);(4)腋窝关节囊厚度大于为4 mm时,诊断Ⅱ期肩周炎的敏感性和特异性分别为92.5%和93.7%;腋窝关节囊厚度大于5.56 mm,诊断Ⅲ期肩周炎的敏感性和特异性分别为68.8%和100.0%。结论:腋窝关节囊的厚度可以作为肩周炎临床分期的参考依据;喙肱韧带厚度以及喙突下脂肪三角受累情况不能作为肩周炎分期的依据。Objective To investigate the relationship between periarthritis of shoulder and axillary recess capsule thickness,coracobrachial ligament and subcoracoid fat triangle involvement.Methods Retrospective analysis was made on the MRI findings of 72 patients(observation group)who were clinically diagnosed as scapulohumeral periarthritis in the 4th Hospital of Changsha from August 2016 to August 2022,and 12 normal healthy people(control group)in the same period.The thickness of coracohumeral ligament,the thickness of axillary recess capsule,and the rate of fat triangle under the coracoid process being replaced by scar tissue were recorded.Results①The thickness of the armpit articular capsule,the thickness of the coracohumeral ligament and the involvement of the fat triangle under the coracoid process were compared between the observation group and the control group,and the difference was statistically significant(P<0.05);②The thickness of axillary recess capsule was compared between the first,second and third stages of the observation group,and the difference was statistically significant(P<0.05);③The thickness of the coracohumeral ligament and the ratio of fat triangle under the coracoid process replaced by scar in the first,second and third stages of the observation group had no statistical significance(P>0.05);④When the thickness of the axillary recess capsule was greater than 4 mm,the sensitivity and specificity of the diagnosis of stage II periarthritis of shoulder were 92.5% and 93.7% respectively;The thickness of the axillary recess capsule is greater than 5.56 mm,and the sensitivity and specificity of diagnosing stage III periarthritis of shoulder are 68.8%and 100.0%respectively.Conclusion The thickness of axillary recess capsule can be used as a reference for clinical staging of periarthritis of shoulder;The thickness of the coracohumeral ligament and the involvement of the fat triangle under the coracoid process cannot be used as the basis for the staging of scapulohumeral periarthritis.

关 键 词：肩周炎 MRI 喙肱韧带 腋窝关节囊 喙突下脂肪三角征 

分 类 号：R445.2[医药卫生—影像医学与核医学]