MRI在肩袖钙化性肌腱炎诊断中的应用价值

The value of MRI in diagnosis of calcific tendinitis of rotator cuff

目的探讨MRI在肩袖钙化性肌腱炎诊断中的应用价值,为临床诊断及手术治疗提供影像学依据。方法回顾性分析21例经临床手术证实为钙化性肌腱炎的患者的影像学资料,所有患者均行MRI检查及X线检查。结果 1)21例X线片显示明确钙盐沉积的病例中,MRI对钙盐沉积的的显示率为86%,于T_1WI及PDWI-FS图像17例钙盐沉积呈低信号,1例呈高低混杂信号,钙盐沉积所累及肌腱相邻区域损伤;2)在钙盐沉积部位中,12例为冈上肌肌腱,3例为冈下肌肌腱,4例同时累及冈上、冈下肌肌腱,1例为肩胛下肌肌腱,1例同时累及冈上、肩胛下肌肌腱;3)21例均合并肩袖损伤,累及冈上肌肌腱者为20例,部分撕裂者为9例;累及肩胛下肌腱者为8例;累及冈下肌腱者为4列;4例合并肱二头肌长头肌腱损伤。结论 MRI在显示细小钙化方面不如X线,单一MRI检查对于钙化性肌腱炎的诊断是不充分的,但MRI对于肌腱炎及钙化物沉积位置的显示要优于X线检查,对临床诊断及手术治疗有较大的诊断价值。

Objective To investigate the clinical value of MRI in diagnosis of calcific tendinitis of rotator cuff,provide images for clinical diagnosis and treatment basis. Methods A retrospective analysis of 21 patient images of surgically confirmed data for calcific tendinitis,all patients underwent MRI examination and X-ray examination. Results 1） 21 cases showed clear calcium deposition of the X-ray,and the display rate of MRI on calcium deposition was 86%,17 cases of calcium deposition showed hypointensity on T1WI and PDWI-FS images,1 cases showed mixture hypo-and hyperintensity on T1WI and PDWI-FS images; 2）The calcification deposit location,12 cases within supraspinatus tendon,3 cases within supraspinatus tendon,4 cases within supraspinatus and infraspinatus tendon,1 case within subscapularis tendon,1 case within the supraspinatus and subscapularis tendon; 3） 21 cases were combined with rotator cuff injury,20 cases were supraspinatus tendon injury,and 9 cases was partial tear;8 cases were subscapularis tendon; 4 cases were infraspinatus tendon; 4 cases also get long head of biceps tendon injury. Conclusion MRI is poorer than X-ray in displaying small calcification,as single MRI is not sufficient in the diagnosis of calcific tendinitis,but MRI is better than X-ray in displaying tendinitis and the location of calcification deposition. MRI is of great diagnostic value in clinical diagnosis and surgical treatment.