肩关节冈上肌出口位与MRI在肩袖损伤诊断中的应用价值对比  

Comparison of the Diagnostic Value of Shoulder Supraspinatus Muscle Outlet and MRI in Rotator Cuff Injury

作　　者：李鑫鑫 李韧 吴露露 LI Xin-xin;LI Ren;WU Lu-lu(Image Centre,The First Hospital of Anhui University of Science&Technology(Huainan First People’s Hospital),Huainan 232000,Anhui Province,China)

机构地区：[1]安徽理工大学第一附属医院(淮南市第一人民医院)影像中心,安徽淮南232000

出　　处：《中国CT和MRI杂志》2024年第11期154-156,共3页Chinese Journal of CT and MRI

摘　　要：目的比较肩袖损伤诊断中肩关节冈上肌出口位数字化X射线摄影(DR)与磁共振成像(MRI)的临床价值。方法选取2022年1月至2024年3月于医院就诊的疑似肩袖损伤的患者80例,均行肩关节冈上肌出口位DR与MRI诊断。以肩关节镜检查结果为“金标准”,比较肩关节冈上肌出口位DR与MRI诊断肩袖损伤的价值。结果肩关节冈上肌出口位DR显示,65例患者肩峰形态为Ⅲ型(钩状,肩峰下方有骨赘形成,肩峰尖端部位处呈现出钩形);52例患者肩峰-肱骨头间隙明显狭窄,肩峰下方有骨赘形成;肌腱不同程度的钙化,钙化在X射线上表现为亮点或斑片状密度增高影;关节间隙狭窄或关节面存在骨质增生;肱骨大结节出现囊性变、硬化及反应性增生等改变。肱骨头或冈上肌起点有骨刺形成。MRI显示,62例患者肩袖肌腱信号增强,T2WI受损肌腱常呈现高信号,T1WI上信号无显著变化;肌腱形态发生改变,43例患者肩袖肌腱变薄,30例增厚,7例不规则;在斜冠状位和斜矢状位上显示肩袖部分或全层撕裂;肌肉横截面积减少和脂肪侵润,考虑存在肌肉萎缩;肩峰下组织增厚或骨赘形成,导致肩袖受压;肩峰下滑囊炎在MRI上表现为滑囊增大,信号增强。MRI诊断肩袖损伤的阳性率高于肩关节冈上肌出口位DR(χ^(2)=4.514,P=0.034)。MRI诊断肩袖损伤的灵敏度、准确度及曲线下面积(AUC)均高于肩关节冈上肌出口位DR。结论MRI诊断肩袖损伤的临床价值高于肩关节冈上肌出口位DR。Objective To compare the clinical value of digital radiography(DR)of the supraspinatus outlet position of the shoulder joint with magnetic resonance imaging(MRI)in the diagnosis of rotator cuff injuries.Methods A total of 80 patients with suspected rotator cuff injuries who visited the hospital from January 2022 to March 2024 were selected.All patients underwent DR and MRI diagnosis of the supraspinatus outlet position of the shoulder joint.The results of the shoulder arthroscopy were used as the"gold standard"to compare the value of DR and MRI in diagnosing rotator cuff injuries.Results DR of the supraspinatus outlet position showed that in 65 patients,the acromial morphology was type III(hook-shaped,with osteophyte formation beneath the acromion,and the acromial tip presented a hook-like shape).In 52 patients,the acromiohumeral distance was significantly narrowed,with osteophyte formation beneath the acromion.Different degrees of tendon calcification,calcification on X-ray as bright spots or patchy increased density shadow.Narrowing of the joint space or osteophyte formation on the joint surface.Cystic changes,sclerosis,and reactive hyperplasia in the greater tuberosity of the humerus.Bone spurs formed on the humeral head or the origin of the supraspinatus muscle.MRI showed that in 62 patients,the signal of the rotator cuff tendon was enhanced,with the damaged tendon often showing high signal on T2WI and no significant change in signal on T1WI.Changes in tendon morphology,with 43 patients showing thinning of the rotator cuff tendon,30 showing thickening,and 7 showing irregularity.Partial or full-thickness tears of the rotator cuff were displayed on oblique coronal and oblique sagittal positions.Reduction in muscle cross-sectional area and fat infiltration,suggesting muscle atrophy.Thickening of subacromial tissue or osteophyte formation,causing compression of the rotator cuff.Subacromial bursitis appeared as an enlarged bursa with enhanced signal on MRI.The positive rate of MRI in diagnosing rotator cuff injuri

关 键 词：肩袖损伤 肩关节冈上肌出口位 数字化X射线摄影 磁共振成像 

分 类 号：R686[医药卫生—骨科学]