肱骨外上髁炎的MRI表现及与伸肌水肿之间的关系

The MRI manifestation of lateral epicondylitis and its relationship with extensor edema

目的分析肱骨外上髁炎的MRI表现,探讨MRI对肱骨外上髁炎诊断价值以及肱骨外上髁炎的MRI分级与伸肌水肿之间的关系。方法 22例患侧肘关节行MRI常规扫描,分析MRI表现,将伸肌总腱的损伤分为Ⅰ级(轻度)、Ⅱ级(中度)、Ⅲ级(重度)。分析肱骨外上髁炎的MRI分级与伸肌水肿之间的关系。结果 MRI图像示22例患者患侧肘关节伸肌总腱均有异常改变,经分析和统计为Ⅰ级(轻度)9个、Ⅱ级(中度)8个、Ⅲ级(重度)5个,伴有伸肌水肿阳性率分别为22%、50%、80%。结论 MRI对肱骨外上髁炎存在高度敏感性,可以作为诊断的重要工具;随着伸肌总腱损伤程度加重,伴有伸肌水肿的可能性明显增加,这有助于全面评价病情,健全治疗方案。

Objective To analyze on the MRI manifestation of lateral epicondylitis and to explore the value of MRI in diagnosis of lateral epicondylitis as well as the relationship between the classification of lateral epicondylitis by MRI and the extensor edema. Methods 22 patients with injured elbows underwent MRI examination. The MRI images were analyzed. The injury of the common extensor tendons were graded as Ⅰ（ mild）,Ⅱ（ moderate） or Ⅲ（ severe）. Then,the relationship between the classification of lateral epicondylitis by MRI and the extensor edema was discussed. Results On MRI images,all 22 patients showed abnormal signal. Through analysis and statistics,we detected that 9 elbows presented with Grade Ⅰ injury of common extensor tendon,8 presented with Grade Ⅱ injury,and 5 presented with Grade Ⅲ injury. The positive rate of extensor edema of Grade Ⅰ injury,Grade Ⅱ injury,and Grade Ⅲ injury was 22%,50%,and 80%,respectively. Conclusion MRI is highly sensitive to lateral epicondylitis,which can be used as an important tool of diagnosis. As the degree of injury of the common extensor tendons aggravating,the possibility accompanied by extensor edema increases significantly,which conduces to comprehensive evaluation of disease and improves the treatment plan.