混杂型肩袖撕裂与肩袖病变磁共振征象对比分析  

Comparative Analysis of MRI Findings of Mixed Rotator Cuff Tears and Rotator Cuff Lesions

作　　者：刘中冲 李智伟[1] 秦妙 刘兆芹 刘丰杰[2] 钱学江 刘雨清[1] LIU Zhongchong;LI Zhiwei;QIN Miao;LIU Zhaoqin;LIU Fengjie;QIAN Xuejiang;LIU Yuqing(School of Basic Medical Sciences,Weifang Medical University,Weifang 261053,China;Department of Medical Imaging,Hospital of the 80th Army of the Chinese People’s Liberation Army,Weifang 261021,China)

机构地区：[1]潍坊医学院基础医学院,山东潍坊261053 [2]中国人民解放军陆军第八十集团军医院医学影像科,山东潍坊261021

出　　处：《中国司法鉴定》2023年第4期52-56,共5页Chinese Journal of Forensic Sciences

基　　金：中国人民解放军陆军第八十集团军医院基金资助项目(202104)。

摘　　要：目的比较肩袖病变与混杂型肩袖撕裂(rotator cuff tears,RCT)磁共振成像(magnetic resonance imaging,MRI)中图像特征的差异,为肩袖撕裂伤病关系判定提供依据。方法回顾性分析87例RCT患者的病历与MRI资料,包括16例肩袖病变与71例混杂型撕裂,其中混杂性撕裂又分为骨折脱位组(22例)和轻度创伤组(49例)。根据MRI图像测量RCT内外侧长度(medial-lateral tear size,ML)、韧带损伤数量、撕裂类型、肌骨挫伤及撕裂端脂肪浸润信号。对三组患者的基线资料和MRI测量参数进行比较。结果ML、撕裂类型、韧带损伤数量和肌骨挫伤信号三组的比较差异具有统计学意义(P<0.05),其中骨折脱位组ML最小、韧带损伤数量最多,轻度创伤组全层撕裂发生率最高。年龄、性别、撕裂端脂肪浸润信号这三组比较差异无统计学意义(P>0.05)。结论依据MRI韧带损伤数量和肌骨挫伤信号可推断创伤大小,但肩袖撕裂内外侧长度、撕裂类型与创伤大小无关。撕裂端脂肪浸润信号发生率低,判断伤病关系价值有限。Objective To compare the difference of MRI signs between rotator cuff lesions and mixed rotator cuff tears,thus to provide a basis for judging the injury-disease relationship of rotator cuff tear(RCT).Methods Retrospective analysis of clinical and MRI data of 87 patients with RCT was carried out.In 16 cases,the patients got rotator cuff lesion,and other 71 cases got mixed type of RCT,which were further divided into fracture dislocation group(22 cases)and mild trauma group(49 cases).The medial-lateral tear size(ML),tear type,number of injured ligaments,musculoskeletal contusion and signal of fat infiltration at the tear end of RCT were measured.The baseline data of the three groups and their MRI measurement parameters were compared.Results There were significant differences in ML,tear type,number of injured ligaments and musculoskeletal contusion among the three groups(P<0.05).The fracture dislocation group had the lowest ML values and the highest ligament injury numbers.The mild trauma group had the highest incidence of full-thickness tear.There was no significant difference in age,gender,and tear end fat infiltration signal among the three groups(P>0.05).Conclusion The trauma size can be inferred from the number of ligament injuries and muscle bone contusion signals on MRI images,but the medial-lateral tear size and type of RCT are not related to the trauma size.The incidence of fat infiltration at the tear end is low,therefore its value in identifying the relationship between injury and disease is limited.

关 键 词：混杂型肩袖撕裂 法医学 伤病关系 磁共振成像 

分 类 号：DF795.4[医药卫生—法医学]