冈上肌出口位投照法联合多层螺旋CT对肩峰分型及其与肩峰下撞击综合征相关性的应用

The application of imaging projection of the supraspinatus outlet in combination with MSCT in shoulder peak acromion typing and its relationship with subacromial impingement syndrome

目的探讨肩峰分型与肩峰下撞击综合征的相关性。方法收集经临床证实的32例肩峰下撞击综合征,将其分为A(35岁以下)、B(36~55岁)、C(55岁以上)3组,分别行冈上肌出口位X线摄影及多层螺旋CT检查,观察肩峰解剖形态并进行分型及测肩峰-肱骨头间距(A-H间距)。结果Ⅰ型6例(18.75%),Ⅱ型9例(28.12%),Ⅲ型17肩(53.13%)。A组5例,其中Ⅰ型3例,Ⅱ型、Ⅲ型各1例;B组10例,其中Ⅰ型2例,Ⅱ型3例,Ⅲ型5例;C组17例,其中Ⅰ型1例,Ⅱ型5例,Ⅲ型11例。结论冈上肌出口位X线摄影及多层螺旋CT检查均可显示肩峰的解剖形态,MSCT的多平面重组(MPR)、容积再现(VR)等重组技术可任意方向及立体显示肩峰的形态,其诊断价值优于冈上肌出口位X线摄影。

Objective To study the relationship between acromion type and subacromial impingement syn- drome. Methods Collected 32 cases of clinically confirmed subacromial impingement syndrome and divided them into group A（under the age of 35）, group B（from 36 to 55 years old） and group C（55 years or older）. X-ray photography and MSCT inspection of the supraspinatus outlet was carried out in each group. Then we observed and typed the anatomical morphology of acromion and measured the space between the aeromion and caput humeri （A-H spacing）. Result Six cases of type I （18.75%）, 9 cases of type Ⅱ （28.12%）, 17 cases of type Ⅲ（53.13%）. There are 5 cases in group A, including 3 cases of type Ⅰ , 1 case of type Ⅱ and 1 case of type Ⅲ. There are 10 cases in group B, in- cluding 2 cases of type Ⅰ , 3 cases of type lI, 5 cases of type Ⅲ. There are 17 cases in group C, including 1 case of type Ⅰ , 5 cases of type Ⅱ, 11 cases of type Ⅲ. Conclusion X-ray photography and MSCT inspection of the supraspinatus outlet can both show the anatomical morphology of aeromion. MPR, VR and other recombinant technology of MSCT can display the morphology of acromion in any direction, which is also stereoscopic. Its diagnostic value is superior to the X-ray photography of the supraspinatus outlet.