MRA测量喙突-肩胛盂上结节和喙突-肱骨头距离对肩袖损伤的评估价值

VALUE OF THE DISTANCES BETWEEN THE CORACOID PROCESS AND THE SUPRAGLENOID TUBERCLE AND BETWEEN THE CORACOID PROCESS AND THE HUMERAL HEAD MEASURED BY MAGNETIC RESONANCE ARTHROGRAPHY IN EVALUATING ROTATOR CUFF INJURY

目的探讨磁共振关节造影(MRA)测量喙突-肩胛盂上结节和喙突-肱骨头距离对肩袖损伤的评估价值。方法回顾性分析145例肩关节MRA检查者,按照损伤部位的不同将病例分为肩胛下肌腱损伤组52例,冈上肌肌腱损伤组54例,正常对照组39例,3组分别在斜矢状位和横轴位上测量喙突-肩胛盂上结节垂直距离及喙突-肱骨头前后距离,比较两种距离与肌腱病理改变的关系。结果冈上肌腱损伤组测量喙突-肩胛盂上结节平均垂直距离较对照组大,差异有统计学意义(t=3.6,P<0.05);喙突-肱骨头前后距离较对照组小,差异有统计学意义(t=-4.5,P<0.05)。肩胛下肌腱损伤组喙突-肱骨头的前后距离、喙突-肩胛盂上结节垂直距离与对照组比较,差异无显著性(P>0.05)。结论肩关节MRA测量的喙突-肩胛盂上结节垂直距离增大和喙突-肱骨头前后距离减小在提示冈上肌腱损伤时有参考意义,但在评估肩胛下肌腱损伤方面价值有限。

Objective To investigate the value of the distances between the coracoid process and the supraglenoid tubercle and between the coracoid process and the humeral head measured by magnetic resonance arthrography(MRA)in evaluating rotator cuff injury.Methods A retrospective analysis was performed for 145 individuals who underwent MRA of shoulder joint,and according to the site of injury,they were divided into subscapularis tendon injury group with 52 patients,supraspinatus tendon injury group with 54 patients,and control group with 39 individuals.The vertical distance between the coracoid process and the supraglenoid tubercle and the anterior-posterior distance between the coracoid process and the humeral head were measured in the oblique sagittal and axial planes,and the association of these two distances with the pathological changes of the tendon was analyzed.Results\Compared with the control group,the supraspinatus tendon injury group had a significantly longer mean vertical distance between the coracoid process and the supraglenoid tubercle(t=3.6,P<0.05)and a significantly shorter anterior-posterior distance between the coracoid process and the humeral head(t=-4.5,P<0.05).There were no significant differences between the subscapularis tendon injury group and the control group in the anterior-posterior distance between the coracoid process and the humeral head and the vertical distance between the coracoid process and the supraglenoid tubercle(P>0.05).Conclusion The increase in the vertical distance between the coracoid process and the supraglenoid tubercle and the reduction in the anterior-posterior distance between the coracoid process and the humeral head measured by MRA arthrography of shoulder joint can provide a reference for supraspinatus tendon injury,with limited values in the assessment of subscapularis tendon injury.