冈上肌出口位数字化断层融合摄影在肩峰下撞击综合征中的应用价值

Application Value of Digital Tomographic Fusion Photography of Supraspinatus Exit Position in Subacromial Impingement Syndrome

目的研究冈上肌出口位数字化断层融合摄影(digital tomosynthesis,DTS)在肩峰下撞击综合征(subacromial impingement syndrome,SIS)中的应用价值。方法前瞻性方便收集该院2017年7月—2019年12月期间经临床诊断为SIS患者108例,根据入排标准最终入组93例作为研究对象。所有患者均行MRI、冈上肌出口位DR及DTS,评估SIS患者引发撞击的主要解剖性指标包括肩峰形态、肩峰下间隙(A-H间距)、肩峰下及肩锁关节骨质增生程度,对比分析3种影像学检查对SIS结构性病因的检出率,并且观察分析冈上肌出口位DTS在SIS的应用价值。结果判断肩峰形态方面冈上肌出口位DTS与MRI及DR检查差异无统计学意义(P>0.05)。观察肩峰下骨质增生及肩锁关节骨质增生方面,3种检查差异有统计学意义(P<0.05);评估A-H间距冈上肌出口位DTS(8.66±1.26)mm与MRI(8.37±1.21)mm和DR(8.89±1.55)mm相比,差异有统计学意义(P<0.05)。结论冈上肌出口位DTS能提高肩关节解剖结构的细节观察能力及准确性,可作为有效的影像学补充检查,在SIS患者临床诊断中具有重要意义。

Objective To study the application value of digital tomosynthesis(DTS)at the exit position of supraspinatus muscle in subacromial impingement syndrome(SIS).Methods Prospectively conveniently collected 108 patients with SIS diagnosed clinically in the hospital from July 2017 to December 2019,and finally enrolled 93 patients as the research object according to the admission criteria.All patients underwent MRI,supraspinatus outlet DR and DTS.The main anatomical indicators of impact in SIS patients were assessed including acromion shape,subacromial space(AH distance),subacromial and acromioclavicular joint bone hyperplasia,to compare and analyze the detection rate of the three kinds of imaging examinations for the structural causes of SIS,and to observe and analyze the application value of DTS at the outlet of the supraspinatus muscle in SIS.Results There was no statistical difference between the DTS and MRI and DR examinations of the supraspinatus exit position in judging the shape of the acromion(P>0.05);observation of subacromial bone hyperplasia and acromioclavicular joint bone hyperplasia,the differences of the three examinations were statistically significant(P<0.05);the difference between the DTS(8.66±1.26)mm and MRI(8.37±1.21)mm and DR(8.89±1.55)mm at the exit position of the supraspinatus muscle at the assessment of the AH distance was statistically significant(P<0.05).Conclusion DTS at the exit position of the supraspinatus muscle can improve the detailed observation ability and accuracy of the anatomical structure of the shoulder joint.It can be used as an effective imaging supplementary examination and is of great significance in the clinical diagnosis of SIS patients.