肩峰下撞击综合征MRI评分与肩关节功能的关系

Correlation Between MRI Score and Shoulder Function in Subacromial Impingement Syndrome

目的评估肩峰下撞击综合征患者MRI结构变化的发生率,确定结构变化与功能的相关程度。资料与方法对39例肩峰下撞击综合征患者行前瞻性研究,均行MRI检查,并计算肩锁关节、肩峰下滑囊和肩袖的MRI评分评估肩部MRI表现,采用肩关节疼痛与功能障碍指数(SPADI)评估治疗前后的肩关节功能,比较治疗前后MRI评分和SPADI评分的变化,以及治疗前MRI评分与SPADI评分变化的相关性。结果治疗前后MRI评分差异无统计学意义(P>0.05),但治疗后SPADI评分明显低于治疗前(47.05±14.68比65.10±9.87,t=16.416,P<0.01)。治疗前MRI评分与治疗前后SPADI评分的变化呈负相关(β=-0.924,95%CI-12.286～-9.310,P<0.01,R^2=0.854)。结论 MRI评分与治疗前后SPADI评分的变化呈负相关,MRI评分越高,治疗后肩关节症状和功能改善效果越差。

Purpose To evaluate the incidence of MRI structural changes in patients with subacromial impingement syndrome, and to determine to what extent the structural change is correlated with function. Materials and Methods A prospective study of 39 patients with subacromial impingement syndrome was performed. All patients underwent MRI examination and MRI scores of acromioclavicular joints, subacromial bursa, and rotator cuff were calculated to assess shoulder MRI performance. Shoulder pain and disability index (SPADI) was adopted for assessment of shoulder function before and after treatment, comparison of changes between MRI score and SPADI score before and after treatment, as well as the correlation between MRI score and SPADI score before treatment. Results There was no statistical significance concerning the difference in MRI scores before and after treatment (P>0.05). However, the SPADI score after treatment was evidently lower than that before treatment (47.05±14.68 vs. 65.10±9.87, t=16.416, P<0.01). The changes of MRI score before treatment was negatively correlated with those of SPADI score before and after treatment (β=-0.924, 95% CI -12.286--9.310, P<0.01, R^2=0.854). Conclusion The MRI score is negatively correlated with the change of SPADI score before and after treatment. The higher the MRI score, the worse the recovery of shoulder joint symptoms and function after treatment.