肩袖间隙MRI参数对粘连性关节炎的诊断价值

Diagnostic value of MRI parameters of the rotator interval in adhesive capsulitis

目的探讨肩袖间隙磁共振增强扫描定量定性参数对粘连性关节炎的诊断价值。方法选择有完整关节镜结果及增强磁共振检查资料103例(粘连性关节炎患者49例、对照组54例),以关节镜结果为标准,比较肩袖间隙是否强化、喙突下脂肪是否消失、肩袖间隙宽度及其厚度、喙肱韧带厚度差异。结果肩袖间隙是否强化、喙突下脂肪是否消失、肩袖间隙(RI)宽度及其厚度、喙肱韧带厚度在诊断粘连性关节炎组与正常组有统计学差异(P<0.05),肩袖间隙是否强化、喙突下脂肪是否消失Kappa值分别为0.98、0.97,敏感度为100%、95.9%,特异度为77.6%、96.3%;RI宽度及其厚度、喙肱韧带厚度ICC值为0.82、0.81、0.84,RI宽度截断值11.95 mm、敏感度82%、特异度90%,RI厚度截断值5.95 mm、敏感度92%、特异度90%。结论定性定量参数肩袖间隙强化、喙突下脂肪消失、肩袖间隙宽度及其厚度有助于对粘连性关节炎的诊断、评估以及治疗计划的精准制定。

Objective To investigate the diagnostic value of quantitative and qualitative MRI parameters of rotator interval(RI)in adhesive capsulitis.Methods Contrast-enhanced MRI of 49 patients with and 54 patients without adhesive capsulitis was retrospectively analyzed.Using arthroscopy results as the gold standard,the width,depth and contrast enhancement of RI,obliteration of the subcoracoid fat,and thickness of the coracohumeral ligament were compared between the two groups.Results There was significant difference in the width(ICC=0.82),depth(ICC=0.81)and contrast enhancement(κ=0.98,100%sensitivity,77.6%specificity)of RI,obliteration of the subcoracoid fat(κ=0.97,95.9%sensitivity,96.3%specificity),and thickness of the coracohumeral ligament(ICC=0.84)between the two groups(P<0.05).The RI width at cut off value of 11.95 mm was 82%sensitive and 90%specific whereas RI depth at cut off value of 5.95 mm was 92%sensitive and 90%specific for diagnosing adhesive capsulitis.Conclusion The qualitative and quantitative MRI parameters of loss of subcoracoid fat,thickness of the coracohumeral ligament,RI width,depth,and contrast enhancement are helpful for diagnosing adhesive capsulitis.